Control console including an input arm for control of a surgical mechanical arm

ABSTRACT

A surgical system comprising: a surgical mechanical arm comprising a plurality of surgical arm sections sequentially coupled by surgical arm joints; an input arm comprising: a plurality of input arm sections sequentially coupled by input arm joints; and an elongate handle: sized and shaped to be held between a human adult&#39;s thumb and one or more finger, coupled to a distal end of said input arm by a flexion joint; and extending proximally with respect to a most distal input arm section so a user grasping said handle bends said flexion joint to hold said handle above other portions of the input arm; at least one sensor configured to measure movement of one or more of said sections; and circuitry configured to receive a measurement signal from said at least one sensor and to generate a control signal, based on said measurement signal for control of movement of said surgical mechanical arm.

RELATED APPLICATIONS

This application is a Continuation-In-Part of U.S. patent applicationSer. No. 15/454,123 filed on Mar. 9, 2017.

This application also claims the benefit of priority under 35 USC §119(e) of U.S. Provisional Patent Application No. 62/583,560, filed onNov. 9, 2017.

This application is also related to co-filed, co-pending and co-assignedCanada Patent Application entitled “CONTROL CONSOLE FOR SURGICAL DEVICEWITH MECHANICAL ARMS” (Attorney Docket No. 73128).

This application is also related to:

-   -   PCT Patent Application No. PCT/IL2015/050893 filed on Sep. 4,        2015,    -   PCT Patent Application No. PCT/IL2015/050892 filed on Sep. 4,        2015,    -   PCT Patent Application No. PCT/IL2015/050891 filed on Sep. 4,        2015, and    -   PCT Patent Application No. PCT/IL2016/050976 filed on Sep. 4,        2016.

The contents of the above applications are all incorporated by referenceas if fully set forth herein in their entirety.

FIELD AND BACKGROUND OF THE INVENTION

The present invention, in some embodiments thereof, relates to a controlconsole and, more particularly, but not exclusively, to a controlconsole including at least one control arm.

SUMMARY OF THE INVENTION

Following are examples of some embodiments of the invention. Features ofone example may be combined with features of one or more other examples,unless expressly prohibited and form additional examples of someembodiments of the invention.

EXAMPLE 1

A control console for control of a medical surgical device comprising atleast one surgical mechanical arm, which control console comprising:

a control console base;

at least one user support coupled to said control console base;

a processor configured to receive data regarding a selected surgicalconfiguration of said at least one surgical mechanical arm and at leastone camera;

an input arm support coupled to said control console base;

at least one input arm comprising a plurality of sections sequentiallycoupled by joints, coupled to and extending from said input arm supportwhere a direction of extension of said input arm, with respect to saidat least one user support is adjustable to match an input armconfiguration to said selected surgical configuration, a camera view ofsaid at least one surgical mechanical arm thereby corresponding to auser view of said input arm.

EXAMPLE 2

The control console according to Example 1, comprising a user interface;

wherein said processor is configured to receive at least a portion ofsaid data from said user interface.

EXAMPLE 3

The control console according to any one of Examples 1-2, comprising auser interface; wherein said user interface is configured to display anindication of a selected surgical configuration.

EXAMPLE 4

The control console according to any one of Examples 1-3, comprising auser interface display configured to display images collected by saidcamera.

EXAMPLE 5

The control console according to any one of Examples 1-4, wherein saiddata comprises one or more of, a direction of insertion of said at leastone surgical mechanical arm, a direction of insertion of said camera, aregion of insertion of said at least one surgical mechanical arm, aregion of insertion of said camera.

EXAMPLE 6

The control console according to any one of Examples 1-5, wherein saidprocessor is configured to receive at least a portion of said data fromat least one control console sensor.

EXAMPLE 7

The control console according to Example 6, wherein said at least onecontrol console sensor is configured to send a signal to said processorbased on said direction of extension of said input arm from said inputarm support.

EXAMPLE 8

The control console according to Example 7, wherein said processor isconfigured to:

compare said signal to said data; and

generate an alarm upon identifying a discrepancy between a selectedsurgical configuration and said direction of extension of said inputarm.

EXAMPLE 9

The control console according to any one of Examples 7-8, wherein saidprocessor is configured to:

compare said signal to said data; and

generate a signal disabling one or more actuator configured to controlmovement of said surgical mechanical upon identifying a discrepancybetween a selected surgical configuration and said direction ofextension of said input arm.

EXAMPLE 10

The control console according to any one of Examples 1-9, wherein saidprocessor is configured to receive at least a portion of said data fromsaid at least one surgical mechanical arm.

EXAMPLE 11

The control console according to any one of Examples 1-10, wherein saidprocessor is configured to receive at least a portion of said data fromsaid camera.

EXAMPLE 12

The control console according to any one of Examples 1-11, wherein aseparation between said at least one input arm and said at least oneuser support is adjustable.

EXAMPLE 13

The control console according to any one of Examples 1-12, wherein saidat least one support comprises a user seat.

EXAMPLE 14

The control console according to any one of Examples 1-13, wherein saidat least one support comprises at least one user arm rest.

EXAMPLE 15

The control console according to any one of Examples 1-14, comprising afirst and a second input arm, according to said at least one input arm.

EXAMPLE 16

The control console according to any one of Examples 1-15, comprising atleast one sensor configured to generate an input arm signal based on ameasured angle between two of said input arm sections;

wherein said a processor is configured to:

-   -   receive said input arm signal;    -   generate a control signal instructing movement of said at least        one surgical mechanical arm, based on said input arm signal;

-   send said control signal to said surgical mechanical arm.

EXAMPLE 17

A system comprising:

a control console according to any one of Examples 1-16;

at least one surgical mechanical arm;

at least one camera;

at least one sensor configured to measure one or more of:

-   -   a position of said surgical mechanical arm with respect to a        position of said camera;    -   a location of insertion into a patient of said surgical        mechanical arm with respect to a location of insertion into a        patient of said camera;

-   a direction of insertion into a patient of said surgical mechanical    arm with respect to a direction of insertion into a patient of said    camera.

EXAMPLE 18

A surgical method comprising:

selecting a surgical approach for at least one surgical mechanical armand a laparoscopic camera; and

adjusting a direction of extension of an input arm from an input armsupport to correspond to said surgical approach;

controlling movement of said surgical mechanical arm using measuredmovement of said input arm.

EXAMPLE 19

The surgical method according to Example 18,

-   wherein said selecting comprises:

selecting a camera insertion direction of a laparoscopic camera into apatient;

selecting an arm insertion direction of a surgical mechanical arm intosaid patient;

-   wherein said adjusting comprises:

adjusting a direction of extension of an input arm from an input armsupport with respect to a user support, where:

-   -   when said camera insertion direction is away from said arm        insertion direction said input arm extends away from said user        support;

-   when said camera insertion direction is towards from said arm    insertion direction said input arm extends towards said user    support.

EXAMPLE 20

The method according to Example 19, wherein said adjusting comprisesadjusting a vertical angle of said direction of extension of said inputarm to correspond to said angle of insertion of said surgical mechanicalarm with respect to an angle of insertion of said laparoscopic camera.

EXAMPLE 21

The method according to any one of Examples 19-20, wherein saidadjusting comprises adjusting a horizontal angle of said direction ofextension of said input arm to correspond to said angle of insertion ofsaid surgical mechanical arm with respect to an angle of insertion ofsaid laparoscopic camera.

EXAMPLE 22

The method according to any one of Examples 19-21, wherein adjustingcomprises adjusting a separation between attachment of said user supportand said input arm support, to maintain a separation between a volume ofallowable positions of said input arm and said user support.

EXAMPLE 23

The surgical method according to Example 18,

-   wherein said selecting comprises: selecting a camera insertion    location of a laparoscopic camera into a patient;

selecting an arm insertion location of a surgical mechanical arm intosaid patient;

-   wherein said adjusting comprises:

comparing a separation between said camera insertion location and an arminsertion location with a threshold;

adjusting a direction of extension of an input arm from an input armsupport with respect to a user support, where:

-   -   when said separation is below said threshold said input arm        extends away from said user support;    -   when said separation is below said threshold extends towards        said user support.

EXAMPLE 24

A control console for control of a medical surgical device comprising atleast one surgical mechanical arm, which control console comprising:

an elongate control console base sized and shaped for a user tocomfortably sit astride said control console base;

at least one input arm coupled to said control console base andcomprising a plurality of sections sequentially coupled by joints;

at least one sensor configured to measure user controlled movement ofsaid sections; and

circuitry configured to receive a measurement signal from said sensorand to generate a control signal, based on said measurement signal forcontrol of movement of said surgical mechanical arm.

EXAMPLE 25

The control console according to Example 24, wherein said elongate baseis 5-30 cm wide.

EXAMPLE 26

The control console according to any one of Examples 24-25, wherein saidelongate base is 0.5-2 m long.

EXAMPLE 27

The control console according to any one of Examples 24-26, comprising aseat coupled to said base.

EXAMPLE 28

The control console according to Example 27, wherein a position of saidseat is adjustable with respect to said base.

EXAMPLE 29

The control console according to any one of Examples 27-28, wherein aseparation between said at least one input arm and said seat isadjustable.

EXAMPLE 30

The control console according to any one of Examples 24-29, comprisingone or more arm rest coupled to said base.

EXAMPLE 31

The control console according to any one of Examples 24-29, comprisingtwo input arms according to said input arm.

EXAMPLE 32

The control console according to any one of Examples 24-31, wherein afootprint of said control console is elongate.

EXAMPLE 33

A surgical method comprising:

providing a surgical mechanical arm comprising:

-   -   an elongate support portion;    -   a first bendable portion coupled to said elongate support        portion;    -   a second bendable portion coupled to said first bendable        portion;    -   a tool coupled to said second bendable portion:

positioning said surgical mechanical arm at a surgical site;

identifying a potential collision between said surgical mechanical armand an obstacle,

bending said surgical mechanical arm at said second bendable portion;and

bending said surgical mechanical arm at said first bendable portion.

EXAMPLE 34

The method according to Example 33, wherein said identifying comprises:identifying, using a processor, based on data received from one or moresensor.

EXAMPLE 35

The method according to Example 34, wherein said one or more sensorincludes a camera configured to collect images including said obstacleand at least a portion of said surgical mechanical arm.

EXAMPLE 36

The method according to any one of Examples 33-35, wherein said obstacleis an inner abdominal wall.

EXAMPLE 37

The method according to Example 36 wherein said obstacle is an innerabdominal wall of an insufflated patient.

EXAMPLE 38

A surgical system for control of a surgical mechanical arm, which systemcomprises:

at least one input arm comprising:

-   -   a first section rotatable about a first section axis;    -   a second section rotatable about a second section axis;    -   a first bendable joint coupling said first and said second        sections, where said first section axis and said second section        axis are not collinear, for all angles of bending of said first        bendable joint;    -   at least one sensor configured to measure movement of one or        more of said sections; and

-   circuitry configured to receive a measurement signal from said at    least one sensor and to generate a control signal, based on said    measurement signal for control of movement of said surgical    mechanical arm.

EXAMPLE 39

The surgical system of Example 38, wherein said where bending at saidbendable joint changes an angle of said first section axis with respectto said second section axis.

EXAMPLE 40

The surgical system of Example 38, wherein said first section isrotatable at a first rotational joint.

EXAMPLE 41

The surgical system of Example 40, wherein said first rotational jointcouples said first section to a support section.

EXAMPLE 42

The surgical system of Example 41, wherein said first rotational jointcouples a proximal portion of said first section to said supportsection.

EXAMPLE 43

The surgical system of Example 42, wherein said bendable joint couples adistal portion of said first portion to a proximal portion of saidsecond section.

EXAMPLE 44

The surgical system of Example 38, wherein said second section isrotatable at a second rotational joint.

EXAMPLE 45

The surgical system of Example 38, wherein when said input arm is in astraight configuration, said first axis and said second axis areparallel.

EXAMPLE 46

The surgical system of Example 45, wherein, when said input arm is insaid straight configuration, there is an offset between said first andsaid second axes.

EXAMPLE 47

The surgical system of Example 46, wherein said offset is 0.01-5%, of amaximum portion cross sectional thickness.

EXAMPLE 48

The surgical system of Example 46 wherein said offset is 1-5 mm.

EXAMPLE 49

The surgical system according to Example 38, wherein said axes ofrotation of said rotational joints are at different separations from anaxis of flexion of a flexion joint disposed between said rotationaljoints.

EXAMPLE 50

The surgical system according to Example 38, where a difference inseparation between said first axis and said second axis as measured atan axis of flexion of said bendable joint is 0.005-5% of a portionthickness.

EXAMPLE 51

The surgical system according to Example 38, where a difference inseparation between said first axis and said second axis as measured atan axis of flexion of said bendable joint is 1-5 mm.

EXAMPLE 52

The surgical system according to Example 38, wherein said bendable jointis a pivot joint.

EXAMPLE 53

The surgical system according to Example 50, wherein said bendable jointis a pivot joint and said axis of flexion is an axis of said pivotjoint.

EXAMPLE 54

The surgical system according to Example 38, wherein said at least onesensor comprises a magnetic sensor connected configured to measuremovement of a magnet mounted to one of said sections.

EXAMPLE 55

The surgical system according to Example 38, wherein said at least onesensor comprises:

a first sensor configured to measure rotation of said first section; and

a second sensor configured to measure rotation of said second section.

EXAMPLE 56

The surgical system according to Example 55, wherein said first sensoris a magnetic sensor configured to configured to measure movement of amagnet configured to rotate with said first section;

wherein said second sensor is a magnetic sensor configured to configuredto measure movement of a magnet configured to rotate with said secondsection.

EXAMPLE 57

The surgical system of Example 38, wherein said bendable joint isbendable by at least 120°.

EXAMPLE 58

The surgical system of Example 38, wherein said bendable joint isbendable by at least 180°.

EXAMPLE 59

The surgical system of Example 44, wherein said second section iscoupled at a distal end to a handle by second bendable joint.

EXAMPLE 60

The surgical system of Example 59, wherein said second section rotatablewith respect to said handle about said second rotational joint.

EXAMPLE 61

A method of surgical device control comprising:

providing an input arm including a first portion rotatable about a firstrotational joint coupled, by a bendable joint, to a second portionrotatable by a second rotational joint;

applying a torque to said first rotatable portion of an input arm torotate sais first rotatable portion about an axis of rotation of saidfirst rotational joint, where torque transferred to said secondrotatable portion is reduced by transfer and is not sufficient toovercome friction at said second rotational joint and rotate said secondrotatable portion.

EXAMPLE 62

The method of Example 61, wherein said axis of rotation of said firstportion and an axis of rotation of said second rotational joint isnon-coaxial with said axis of said first rotational joint reducing saidtorque transferred to said second rotatable.

EXAMPLE 63

A surgical system comprising:

a surgical mechanical arm comprising a plurality of sectionssequentially coupled by joints;

an input device for control of a surgical mechanical arm comprising:

-   -   a plurality of sections sequentially coupled by input arm        joints, where said plurality of sections includes a handle;    -   at least one sensor configured to measure user controlled        movement of said sections;    -   a user interface disposed on said handle whereby an orientation        of said user interface moves under friction between a user and        the user interface, as a user moves the handle; and

circuitry configured to receive a measurement signal from said sensorand to generate a control signal, based on said measurement signal forcontrol of movement of said surgical mechanical arm.

EXAMPLE 64

The surgical system according to Example 1, comprising at least oneactuator configured to:

receive said control signal; and

move at least one of said surgical arm sections, based on said controlsignal.

EXAMPLE 65

The surgical system according to any one of Examples 63-64, comprisingcircuitry configured to receive a signal from said user interface and togenerate a user interface control signal, based on said signal receivedfrom said user interface.

EXAMPLE 66

The surgical system according to Example 65, comprising at least oneactuator

configured to:

receive said user interface control signal; and

move at least one of said surgical arm sections, based on said controlsignal.

EXAMPLE 67

The surgical system according to Example 66, wherein said surgicalmechanical arm comprises a surgical tool;

wherein said actuator actuates said surgical tool.

EXAMPLE 68

The surgical system according to Example 67, wherein said surgical toolis connected to a distal end of said surgical mechanical arm.

EXAMPLE 69

The surgical system according to any one of Examples 63-68, wherein saiduser interface is a switch.

EXAMPLE 70

The surgical system according to Example 69, wherein said user interfaceis biased in an open position.

EXAMPLE 71

The surgical system according to any one of Examples 63-70, whereinfriction between said user interface and a user's hand, when a user istouching the user interface is sufficient to change an orientation ofsaid user interface as the user moves said handle.

EXAMPLE 72

A method of surgical device control comprising:

changing an orientation of a handle of an input device with respect to auser hand;

adjusting an orientation of a user interface with respect to said handleto maintain an orientation of a user interface disposed on said handlewith respect to said user hand.

EXAMPLE 73

The method according to Example 72, wherein said adjusting comprisesmoving said user interface under friction between at least a portion ofsaid user interface and a portion of a user's hand.

EXAMPLE 74

A surgical system comprising:

a surgical mechanical arm comprising a plurality of surgical armsections sequentially coupled by surgical arm joints;

an input arm comprising:

-   -   a plurality of input arm sections sequentially coupled by input        arm joints; and

an elongate handle, coupled to a distal end of said input arm andcomprising:

-   -   a rotatable body of said handle; and    -   a user interface coupled to said body;

at least one sensor configured to measure rotation of said rotatableportion;

wherein a processor configured to receive a measurement signal from saidsensor and a user interface signal from said user interface generates acontrol signal, based on said measurement signal and said user interfacesignal, instructing control of rotation of a surgical arm section.

EXAMPLE 75

The surgical system according to Example 74, wherein said user interfaceis a second rotatable portion, rotatable with respect to said handle.

EXAMPLE 76

The surgical system according to Example 75, wherein said user interfaceis a dial coupled to said handle and rotatable with respect to saidhandle.

EXAMPLE 77

The surgical system according to Example 76, wherein said dial isdisposed on an end of said handle coupled to said input arm.

EXAMPLE 78

The surgical system according to Example 74, wherein said rotatableportion is an elongate body of said handle, rotatable about a long axisof said elongate body.

EXAMPLE 79

The surgical system according to any one of Examples 74-78, wherein saidat least one sensor comprises a magnetic sensor configured to measuremovement of a magnet configured to rotate with said rotatable portion.

EXAMPLE 80

The surgical system according to Example 75, wherein said at least onesensor comprises:

a first sensor configured to measure rotation of said rotatable portion;and a second sensor configured to measure rotation of said secondrotational portion.

EXAMPLE 81

The surgical system according to Example 80, wherein said first sensoris a magnetic sensor configured to configured to measure movement of amagnet configured to rotate with said rotatable portion;

wherein said second sensor is a magnetic sensor configured to configuredto measure movement of a magnet configured to rotate with said secondrotatable portion.

EXAMPLE 82

A surgical system for control of a surgical mechanical arm, which systemcomprises:

at least one input arm comprising:

-   -   a plurality of sections;    -   a plurality of joints sequentially coupling said plurality of        sections;    -   at least one sensor configured to measure movement of one or        more of said sections; and    -   a weight attached to one of said plurality of sections which        biases said one of said plurality of sections to a null        configuration, by movement under gravity of said one of said        plurality of sections about one or more of said joints; and

-   circuitry configured to receive a measurement signal from said at    least one sensor and to generate a control signal, based on said    measurement signal for control of movement of said surgical    mechanical arm.

EXAMPLE 83

The surgical system of Example 82, wherein said weight is sufficient toovercome friction of movement of said section about one or more jointcoupling said section to one or more adjacent section.

EXAMPLE 84

The surgical system according to any one of Examples 82-83, wherein saidjoints include one or more rotational joint.

EXAMPLE 85

The surgical system according to Example 84, wherein said weight iscoupled to a section which rotates about a rotational joint;

wherein said section rotates about said rotational joint to return tosaid section to said null configuration.

EXAMPLE 86

The surgical system according to Example 85, wherein said section iscoupled to a flexion joint.

EXAMPLE 87

The surgical system according to Example 86, wherein said flexion jointis bendable in a single bending plane.

EXAMPLE 88

The surgical system according to any one of Examples 86-87, wherein saidat least one sensor is configured to measure an angle at said flexionjoint, where said angle is an angle between adjacent sections connectedby said joint.

EXAMPLE 89

The surgical system according to Example 87, wherein said flexion jointis bendable in one rotational direction about said single bending planefrom a straight configuration.

EXAMPLE 90

The surgical system according to Example 89, wherein said plurality ofsections are coupled to a support.

EXAMPLE 91

The surgical system according to Example 90, wherein said weight biasessaid flexion joint such that an axis of said flexion joint is above atop of said support.

EXAMPLE 92

The surgical system according to Example 91, wherein said weight biasessaid flexion joint in an orientation where bending at said flexionjoint, by less than 90°, about said single bending plane from a straightconfiguration in said rotational direction moves a section distal andadjacent to said flexion joint away from said support.

EXAMPLE 93

The surgical system according to any one of Examples 90-92, wherein saidweight biases said flexion joint such that said rotational direction isin a generally upwards direction.

EXAMPLE 94

The surgical system according to any one of Examples 85-93, wherein aweight is coupled to an input section adjacent to each said rotationaljoint.

EXAMPLE 95

The surgical system according to any one of Examples 82-94, wherein saidinput arm sections are alternatively coupled by rotational and flexionjoints.

EXAMPLE 96

The surgical system according to Example 95, wherein said flexion jointsare bendable in a single bending plane.

EXAMPLE 97

The surgical system according to Example 96, wherein said flexion jointsare bendable in one rotational direction about said single bending planefrom a straight configuration.

EXAMPLE 98

The surgical system according to any one of Examples 95-97, wherein oneor more of said flexion joints include ball bearings.

EXAMPLE 99

The surgical system according to any one of Examples 95-97, wherein oneor more of said rotational joints include ball bearings.

EXAMPLE 100

The surgical system according to Example 82-99, wherein said input armincludes a first flexion joint, a second flexion joint, a firstrotational joint and a second rotational joint.

EXAMPLE 101

The surgical system according to Example 100,

wherein said first rotational joint couples a first input arm section toan input arm support;

wherein said first flexion joint couples a second input arm section tosaid first input arm section;

wherein said second rotational joint couples a third input arm sectionto said second input arm section;

wherein said second flexion joint couples a fourth input arm section tosaid third input arm section;

wherein a handle section is coupled to said third input arm section.

EXAMPLE 102

The surgical system according to Example 101, comprising:

-   a first weight coupled to said second section, said first weight    configured to maintain an axial orientation of said second section.

EXAMPLE 103

The surgical system according to Example 102, comprising:

a second weight coupled to said fourth section, said second weightconfigured to maintain an axial orientation of said fourth section.

EXAMPLE 104

The surgical system of Example 97, wherein said flexion joints are pivotjoints.

EXAMPLE 105

The surgical system of Example 97, wherein one or more of said flexionjoints are bendable by at least 120°.

EXAMPLE 106

The surgical system of Example 97, wherein one or more of said flexionjoints are bendable by at least 180°.

EXAMPLE 107

The surgical system of Example 97, wherein each of said flexion jointsare bendable by at least 120°.

EXAMPLE 108

The surgical system of Example 97, wherein each of said flexion jointsare bendable by at least 180°.

EXAMPLE 109

A surgical system comprising:

a surgical mechanical arm comprising a plurality of surgical armsections sequentially coupled by surgical arm joints;

an input arm comprising:

-   -   a plurality of input arm sections sequentially coupled by input        arm joints; and    -   an elongate handle:        -   sized and shaped to be held between a human adult's thumb            and one or more finger, where a maximum dimension of said            handle perpendicular to a handle long axis is 5 mm-15 mm and            a long axis length of said handle is 20-200 mm;    -   coupled to a distal end of said input arm by a flexion joint;        and    -   extending proximally with respect to a most distal input arm        section so that a user grasping said handle bends said flexion        joint to hold said handle above other portions of the input arm    -   at least one sensor configured to measure movement of one or        more of said sections; and    -   circuitry configured to receive a measurement signal from said        at least one sensor and to generate a control signal, based on        said measurement signal for control of movement of said surgical        mechanical arm.

EXAMPLE 110

The surgical system of Example 109, where one or more of said pluralityof sections are sized such that a user holding said elongate handle isable to support one or more section with the user's palm of the handholding the handle.

EXAMPLE 111

The surgical system of Example 110, wherein a portion of said input armincludes a protrusion which protrudes from a body of said input arm,said protrusion at a distance from said handle and sized and shaped tobe held in a user's palm of a hand holding the handle.

EXAMPLE 112

The surgical system of Example 111, wherein said protrusion is at leasta portion of a flexion joint.

EXAMPLE 113

The surgical system according to Example 109, wherein said input armssections are alternatively coupled by rotational and flexion joints.

EXAMPLE 114

The surgical system according to Example 113, wherein said flexionjoints are bendable in a single bending plane.

EXAMPLE 115

The surgical system according to Example 114, wherein one or more ofsaid flexion joints is bendable by at least 120°.

EXAMPLE 116

The surgical system according to Example 114, wherein one or more ofsaid flexion joints is bendable by at least 180°.

EXAMPLE 117

The surgical system according to Example 116, wherein said flexionjoints are bendable in one rotational direction about said singlebending plane from a straight configuration.

EXAMPLE 118

The surgical system according to any one of Examples 109-117, whereinsaid input arm includes a first flexion joint, a second flexion joint, afirst rotational joint and a second rotational joint.

EXAMPLE 119

The surgical system according to Example 118, wherein said flexionjoints are each bendable by at least 120°.

EXAMPLE 120

The surgical system according to any one of Examples 109-119, whereinsaid handle extends proximally with respect to a most distal input armsection.

EXAMPLE 121

The surgical system according to any one of Examples 109-120, whereinsaid handle extends towards a most distal input arm joint.

EXAMPLE 122

The surgical system according to Example 121, wherein said most distalinput arm joint is a flexion joint.

EXAMPLE 123

The surgical system according to any one of Examples 109-122, wherein along axis length of said handle is 30-100% of a maximum length of saidinput arm.

EXAMPLE 124

The surgical system according to any one of Examples 109-123, whereinsaid handle comprises:

a rotatable portion;

at least one sensor configured to measure rotation of said rotatableportion;

-   wherein a processor configured to receive a measurement signal from    said sensor generates a control signal, based on said measurement    signal, instructing control of rotation of a surgical arm section.

EXAMPLE 125

The surgical system according to Example 124, wherein said rotatableportion is a dial coupled to said handle and rotatable with respect tosaid handle.

EXAMPLE 126

The surgical system according to Example 125, wherein said dial isdisposed on an end of said handle coupled to said input arm.

EXAMPLE 127

The surgical system according to Example 124, wherein said rotatableportion is an elongate body of said handle, rotatable about a long axisof said elongate body.

EXAMPLE 128

The surgical system according to Example 124, wherein said handlecomprises a second rotatable portion;

-   wherein said at least one sensor is configured to measure rotation    of said second rotatable portion.

EXAMPLE 129

The surgical system according to Example 128, wherein said firstrotatable portion is a dial coupled to said handle and rotatable withrespect to said handle; and

wherein said second rotatable portion an elongate body of said handle,rotatable about a long axis of said elongate body.

EXAMPLE 130

The surgical system according to any one of Examples 128-129, whereinsaid at least one sensor comprises:

-   -   a first sensor configured to measure rotation of said first        rotatable portion; and    -   a second sensor configured to measure rotation of said second        rotatable portion.

EXAMPLE 131

A control console for control of a medical surgical device comprising:

a control console base;

a seat attached to said control console base;

an input arm attached to said control console base comprising:

-   -   a support coupled to said control console base;    -   a proximal end coupled to said support;    -   a distal end;    -   a handle section;    -   a plurality of sections sequentially coupled by input arm        joints, extending from said proximal end where said plurality of        sections terminates at said distal end with said handle section;

an armrest attached to said control console base;

a first volume of possible positions of said handle section said firstvolume defined by lengths of said sections and;

a second volume of user hand positions when a user sitting at said seatresting a forearm of said user on said armrest, said second volumedefined by a position of said armrest and by a size of said user arm;

wherein said first volume is contained by said second volume, foraverage human adult arm dimensions.

EXAMPLE 132

The control console according to Example 131, wherein said handleextends proximally with respect to a most distal input arm section.

EXAMPLE 133

The control console according to any one of Examples 131-132, whereinsaid handle extends towards a most distal input arm joint.

EXAMPLE 134

The control console according to any one of Examples 131-133, wherein along axis length of said handle is 30-100% of a maximum length of saidinput arm.

EXAMPLE 135

The control console according to any one of Examples 131-134, whereinsaid first volume is a portion of a sphere.

EXAMPLE 136

The control console according to Example 135, wherein said sphere is of200-500 mm diameter.

EXAMPLE 137

The control console according to any one of Examples 131-136, whereinsaid second volume is a volume of human adult hand positions.

EXAMPLE 138

The control console according to any of Examples 131-137, comprising afirst input arm and a second input arm coupled to said control baseaccording to said input arm, said first volume of said first input armcontained by a second volume of a first user hand, said first volume ofsaid second input arm contained by a second volume of a second userhand.

EXAMPLE 139

The control console according to Example 138, comprising a first armrestand a second armrest;

wherein said second volume of said first user hand is defined by aposition of said first armrest; and

-   wherein said second volume of said second user hand is defined by a    position of said second armrest.

EXAMPLE 140

The control console according to any one of Examples 131-139, whereinsaid input arms sections are alternatively coupled by rotational andflexion joints.

EXAMPLE 141

The control console according to Example 140, wherein said flexionjoints are bendable in a single bending plane.

EXAMPLE 142

The control console according to Example 141, wherein said flexionjoints are bendable in one rotational direction about said singlebending plane from a straight configuration.

EXAMPLE 143

The control console according to any one of Examples 131-142, whereinsaid input arm includes a first flexion joint, a second flexion joint, afirst rotational joint and a second rotational joint.

Unless otherwise defined, all technical and/or scientific terms usedherein have the same meaning as commonly understood by one of ordinaryskill in the art to which the invention pertains. Although methods andmaterials similar or equivalent to those described herein can be used inthe practice or testing of embodiments of the invention, exemplarymethods and/or materials are described below. In case of conflict, thepatent specification, including definitions, will control. In addition,the materials, methods, and examples are illustrative only and are notintended to be necessarily limiting.

Implementation of the method and/or system of embodiments of theinvention can involve performing or completing selected tasks manually,automatically, or a combination thereof. Moreover, according to actualinstrumentation and equipment of embodiments of the method and/or systemof the invention, several selected tasks could be implemented byhardware, by software or by firmware or by a combination thereof usingan operating system.

For example, hardware for performing selected tasks according toembodiments of the invention could be implemented as a chip or acircuit. As software, selected tasks according to embodiments of theinvention could be implemented as a plurality of software instructionsbeing executed by a computer using any suitable operating system. In anexemplary embodiment of the invention, one or more tasks according toexemplary embodiments of method and/or system as described herein areperformed by a data processor, such as a computing platform forexecuting a plurality of instructions. Optionally, the data processorincludes a volatile memory for storing instructions and/or data and/or anon-volatile storage, for example, a magnetic hard-disk and/or removablemedia, for storing instructions and/or data. Optionally, a networkconnection is provided as well. A display and/or a user input devicesuch as a keyboard or mouse are optionally provided as well.

As will be appreciated by one skilled in the art, aspects of the presentdisclosure may be embodied as a system, method or computer programproduct. Accordingly, aspects of the present disclosure may take theform of an entirely hardware embodiment, an entirely software embodiment(including firmware, resident software, micro-code, etc.) or anembodiment combining software and hardware aspects that may allgenerally be referred to herein as a “circuit,” “module” or “system.”Furthermore, some embodiments of the present disclosure may take theform of a computer program product embodied in one or more computerreadable medium(s) having computer readable program code embodiedthereon. Implementation of the method and/or system of some embodimentsof the disclosure can involve performing and/or completing selectedtasks manually, automatically, or a combination thereof. Moreover,according to actual instrumentation and equipment of some embodiments ofmethods, systems, and/or computer program products of the presentdisclosure, several selected tasks could be implemented by hardware, bysoftware or by firmware and/or by a combination thereof, e.g., using anoperating system.

For example, hardware for performing selected tasks according to someembodiments of the present disclosure could be implemented as a chip ora circuit. As software, selected tasks according to some embodiments ofthe present disclosure could be implemented as a plurality of softwareinstructions being executed by a computer using any suitable operatingsystem. In an exemplary embodiment, one or more tasks according to someexemplary embodiments of method and/or system as described herein areperformed by a data processor, such as a computing platform forexecuting a plurality of instructions. Optionally, the data processorincludes a volatile memory for storing instructions and/or data and/or anon-volatile storage, for example, a magnetic hard-disk and/or removablemedia, for storing instructions and/or data. Optionally, a networkconnection is provided as well. A display and/or a user input devicesuch as a keyboard or mouse are optionally provided as well.

Any combination of one or more computer readable medium(s) may beutilized for some embodiments. The computer readable medium may be acomputer readable signal medium or a computer readable storage medium. Acomputer readable storage medium may be, for example, but not limitedto, an electronic, magnetic, optical, electromagnetic, infrared, orsemiconductor system, apparatus, or device, or any suitable combinationof the foregoing. More specific examples (a non-exhaustive list) of thecomputer readable storage medium would include the following: anelectrical connection having one or more wires, a portable computerdiskette, a hard disk, a random access memory (RAM), a read-only memory(ROM), an erasable programmable read-only memory (EPROM or Flashmemory), an optical fiber, a portable compact disc read-only memory(CD-ROM), an optical storage device, a magnetic storage device, or anysuitable combination of the foregoing. In the context of this document,a computer readable storage medium may be any tangible medium that cancontain, or store a program for use by or in connection with aninstruction execution system, apparatus, or device.

A computer readable signal medium may include a propagated data signalwith computer readable program code embodied therein, for example, inbaseband or as part of a carrier wave. Such a propagated signal may takeany of a variety of forms, including, but not limited to,electro-magnetic, optical, or any suitable combination thereof. Acomputer readable signal medium may be any computer readable medium thatis not a computer readable storage medium and that can communicate,propagate, or transport a program for use by or in connection with aninstruction execution system, apparatus, or device.

Program code embodied on a computer readable medium and/or data usedthereby may be transmitted using any appropriate medium, including butnot limited to wireless, wireline, optical fiber cable, RF, etc., or anysuitable combination of the foregoing.

Computer program code for carrying out operations for some embodimentsof the present disclosure may be written in any combination of one ormore programming languages, including an object oriented programminglanguage such as Java, Smalltalk, C++ or the like and conventionalprocedural programming languages, such as the “C” programming languageor similar programming languages. The program code may execute entirelyon the user's computer, partly on the user's computer, as a stand-alonesoftware package, partly on the user's computer and partly on a remotecomputer or entirely on the remote computer or server. In the latterscenario, the remote computer may be connected to the user's computerthrough any type of network, including a local area network (LAN) or awide area network (WAN), or the connection may be made to an externalcomputer (for example, through the Internet using an Internet ServiceProvider).

Some embodiments of the present disclosure may be described below withreference to flowchart illustrations and/or block diagrams of methods,apparatus (systems) and computer program products. It will be understoodthat each block of the flowchart illustrations and/or block diagrams,and combinations of blocks in the flowchart illustrations and/or blockdiagrams, can be implemented by computer program instructions. Thesecomputer program instructions may be provided to a processor of ageneral purpose computer, special purpose computer, or otherprogrammable data processing apparatus to produce a machine, such thatthe instructions, which execute via the processor of the computer orother programmable data processing apparatus, create means forimplementing the functions/acts specified in the flowchart and/or blockdiagram block or blocks.

These computer program instructions may also be stored in a computerreadable medium that can direct a computer, other programmable dataprocessing apparatus, or other devices to function in a particularmanner, such that the instructions stored in the computer readablemedium produce an article of manufacture including instructions whichimplement the function/act specified in the flowchart and/or blockdiagram block or blocks.

The computer program instructions may also be loaded onto a computer,other programmable data processing apparatus, or other devices to causea series of operational steps to be performed on the computer, otherprogrammable apparatus or other devices to produce a computerimplemented process such that the instructions which execute on thecomputer or other programmable apparatus provide processes forimplementing the functions/acts specified in the flowchart and/or blockdiagram block or blocks.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)

Some embodiments of the invention are herein described, by way ofexample only, with reference to the accompanying drawings. With specificreference now to the drawings in detail, it is stressed that theparticulars shown are by way of example and for purposes of illustrativediscussion of embodiments of the invention. In this regard, thedescription taken with the drawings makes apparent to those skilled inthe art how embodiments of the invention may be practiced.

In the drawings:

FIG. 1 is a simplified schematic of a surgical system, according to someembodiments of the invention;

FIG. 2 is a simplified schematic of a surgical system, according to someembodiments of the invention;

FIGS. 3A-B are simplified schematic views of a control console,according to some embodiments of the invention;

FIG. 3C is an enlarged portion of FIG. 3B according to some embodimentsof the invention;

FIG. 3D is a simplified schematic side view of an input arm, accordingto some embodiments of the invention;

FIG. 3E is a simplified schematic view of an input arm, according tosome embodiments of the invention;

FIG. 3F is a simplified schematic cross sectional view of a portion ofan input device handle, according to some embodiments of the invention;

FIGS. 3G-I are simplified schematic views of configurations of an inputarm and outer contours of potential positions of the input arm,according to some embodiments of the invention;

FIG. 4A is a simplified schematic isometric view of an input arm,according to some embodiments of the invention;

FIG. 4B is a simplified schematic section view of an input arm,according to some embodiments of the invention;

FIG. 4C is a simplified schematic view of a portion of an input deviceincluding a first rotational joint, according to some embodiments, ofthe invention;

FIG. 4D is a simplified schematic view of a portion of an input deviceincluding a second rotational joint, according to some embodiments, ofthe invention;

FIG. 5 is a simplified schematic side view of an input arm, according tosome embodiments of the invention;

FIGS. 6A-B are simplified views of an input arm handle, according tosome embodiments of the invention;

FIGS. 7, 8, 9 and 10 are exemplary simplified schematic configurationsof an input arm and corresponding configurations of a surgicalmechanical arm, according to some embodiments of the invention;

FIG. 11 is a flow chart of a method of surgical device control,according to some embodiments of the invention;

FIGS. 12A-C are simplified schematics of a surgical system including acontrol console configured for a surgical configuration where aplurality of surgical devices are inserted into a patient from differentdirections and/or at different insertion regions, according to someembodiments of the invention;

FIGS. 13A-B are simplified schematic side views of a plurality ofsurgical devices inserted through the same insertion region of apatient, according to some embodiments of the invention;

FIG. 13C is a side view of a control console configured to correspond toa surgical configuration of FIG. 13A and/or FIG. 13B, according to someembodiments of the invention;

FIG. 14A is a side view of a simplified schematic of a plurality ofsurgical devices inserted through the same insertion region of apatient, according to some embodiments of the invention;

FIG. 14B is a top view of a simplified schematic of a plurality ofsurgical devices inserted through the same insertion region of apatient, according to some embodiments of the invention;

FIG. 14C is a top view of a control console configured to correspond toa surgical configuration of FIGS. 14A-B, according to some embodimentsof the invention;

FIG. 15 is a simplified schematic of a surgical system including acontrol console configured for a surgical configuration where aplurality of surgical mechanical arms are inserted through a pluralityof ports according to some embodiments of the invention;

FIG. 16 is a simplified schematic of a surgical system including acontrol console configured for a surgical configuration where aplurality of surgical devices are inserted into a patient at differentinsertion regions, according to some embodiments of the invention;

FIG. 17A is a simplified schematic of a control console where an inputarm is orientated in a forwards configuration, according to someembodiments of the invention;

FIG. 17B is a simplified schematic of a user using a control consolewhere an input arm is orientated in a forwards configuration, accordingto some embodiments of the invention;

FIG. 18A is a simplified schematic of a control console where an inputarm is orientated in a backwards configuration, according to someembodiments of the invention;

FIG. 18B is a simplified schematic of a user using a control consolewhere an input arm is orientated in a backwards configuration, accordingto some embodiments of the invention;

FIG. 19 is a flow chart of a method of surgical mechanical arm movementcontrol, according to some embodiments of the invention;

FIG. 20 is a simplified schematic of a user manipulating an input arm,according to some embodiments of the invention;

FIG. 21 is a simplified schematic side view of a surgical mechanicalarm, in different configurations, according to some embodiments of theinvention;

FIG. 22 is a flow chart of a method of surgical device retroflection,according to some embodiments of the invention;

FIGS. 23A-E are simplified schematic top views of an input arm,according to some embodiments of the invention; and

FIGS. 24A-B are simplified schematic side views of an input arm,according to some embodiments of the invention.

DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION

The present invention, in some embodiments thereof, relates to a controlconsole and, more particularly, but not exclusively, to a controlconsole including at least one control arm.

Overview

A broad aspect of some embodiments of the invention relates to a mobilecontrol console including at least one input arm for control of asurgical system including at least one surgical device. In someembodiments, at least one surgical device is a surgical mechanical armwhere movement of the surgical mechanical arm is controlled by measuredmovement of the input arm.

In some embodiments, the control console is configured to be easilypositioned and/or repositioned by a user before and/or during a surgery.In some embodiments, user control of the system, for example, at acontrol console, is mechanically decoupled from the surgical instrument.

In some embodiments, a control console has an elongate footprint, forexample, with a footprint aspect ratio of 1:1.1-1:20, or 1:1.1-1:5, or1:1-1:3, or lower or higher or intermediate ranges or aspect ratios. Insome embodiments, a control console base to which one or more input armand/or one or more user support are attached (e.g. base) is elongate,e.g. with an aspect ratio of 1:1.1-1:20, or 1:1.1-1:5, or 1:1-1:3, orlower or higher or intermediate ranges or aspect ratios.

In some embodiments, the control console is configured to be sat on by auser. In some embodiments, a use sits astride a portion of the controlconsole, for example astride a control console base. In someembodiments, one or more user support is coupled to the base and/or oneor more input arm.

In some embodiments, the base is configured so that a user can move thecontrol console with user feet e.g. while the user sits astride thecontrol console. For example, where one or more wheel is coupled to thebase where the wheels have sufficiently low friction and/or the controlconsole is light enough for the user to move the control console. Forexample, in some embodiments, the control console includes one or moreuser support e.g. including a user seat. In some embodiments, a weightof a user seated on the control console contributes to stability of thecontrol console e.g. potentially enabling the console to be lighter.

For example, in some embodiments, the control console is small (e.g.less than 3×2 meters, or less than 2×1 meters, or lower or higher orintermediate footprint areas or ranges of footprint areas) and/or light(e.g. weighing less than 200 kg, or less than 150 kg, or less than 100kg, or about 80 kg, or 20-100 kg, or 60-80 kg, or about 72 kg or loweror higher or intermediate weights or ranges of weights), and/or movesunder application of a small force e.g. moves under a manual forceeasily applied by a single user, for example, 1-50 Kgf, or 5-15 Kgf, or7-12 Kgf, or about 10 Kgf, or lower or higher or intermediate ranges orforces In some embodiments, the control console includes one or morewheel on which the control console is configured to move.

In some embodiments, the control console is configured such that a userusing the control console is able to be positioned close to the patientbeing treated by the at least one surgical instrument. For example, anaverage and/or minimum distance between one or more edge (e.g. frontedge) of the control console and a center of a control console seat is0.5-3 m, or 0.5-2 m or 0.8-1.3 m or 0.95-1.19 m or about 1 m, forexample, when the control console is not sterile. In some embodiments, adistance between a side of the control console and a center of a controlseat is smaller, for example, less than half the distance between afront (and/or back) edge of the control console and the seat forexample, 0.1-2 m, or 0.5-1.3 m or 0.5-1 or about.

In some embodiments, one or more portion of the control console issterile. Potentially enabling the control console to be positioned closeto a patient. Where, in some embodiments, an average and/or minimumdistance between one or more edge of the control console and a seat ofthe control console is about 0.5-200 cm, or 1-50 cm, or 1-20 cm or 1-10cm or lower or higher or intermediate distances or ranges.

In some embodiments, the control console is sized and/or shaped suchthat the user is able to see at least a portion of the patient whilstusing the control console. For example, in some embodiments, a maximumheight of the control console (e.g. height of top of a display) above aseat of the control console is about 20-100 cm, or 20-70 cm or 30-60 cm,or 36-53 cm, or lower or higher or intermediate distances or ranges.

In some embodiments, the control console is configured (e.g. sizedand/or shaped) to be positioned between a patient's legs e.g. wherepatient legs are spread e.g. when one or more surgical device isinserted into a patient's undercarriage (e.g. through a natural orificee.g. vagina and/or anus).

In some embodiments, the control console is configured to be locatedabove a patient and/or for the user to be positioned above the patient.Potentially providing a user with improved view of the patient duringuse of the console. In some embodiments, the control console isconfigured to be connected (e.g. hung from) a ceiling.

A broad aspect of some embodiments of the invention relates to an inputarm, where movement of the input arm controls movement of a surgical armand a direction of extension of the input arm from a support withrespect to a user and/or user support is orientated, based on a spatialrelationship between the surgical arm and a camera, where the user viewsimages of the surgical arm collected by the camera (e.g. on a userinterface). In some embodiments, the surgical arm and/or camera isinserted into a patient e.g. during laparoscopic treatment of thepatient. A potential advantage of user control of a surgical arm bymoving an input arm, where a user view of the input arm corresponds witha view of displayed images of the surgical arm is intuitive control ofthe surgical arm by the user.

In some embodiments, the direction of extension of the input arm isbased on a direction of extension of the surgical mechanical arm withrespect to a field of view (FOV) of the camera.

In some embodiments, the surgical mechanical arm includes a rigidportion coupled to a portion including at least one joint e.g. aplurality of joints. In some embodiments, the direction of extension ofthe input arm is based on an angle of the surgical arm rigid portionwith respect to the camera. Where the angle of the surgical arm rigidportion is measured with respect to a direction of insertion of thecamera e.g. an angle of a support of the camera and/or a center of thecamera's FOV.

In some embodiments, insertion points (e.g. incision/s and/or ports) ona patient for a surgical arm and a laparoscopic camera are selected and,in some embodiments, a direction of extension of the input arm from aninput arm support is orientated based on a separation between theinsertion points.

Where, for example, in some embodiments, the surgical arm and camera areinserted through the same region of a patient and the surgical arm isadvanced further into the patient than the camera, such that at least aportion of the surgical arm (e.g. a distal end of the surgical arm) iswithin the camera FOV. The input arm is adjusted to extend away from theuser and/or a user support (e.g. arm rest and/or seat), in someembodiments, the camera view of the surgical arm extending away from thecamera corresponds with the user's view of the input arm extending awayfrom the user. Where extending away, in some embodiments, means thatproximal portion/s of the surgical arm are in the foreground of thecamera images and distal portion/s of the surgical arm are in thebackground of camera images, at least when the surgical arm is in astraight configuration. During control of the surgical arm using theinput arm, a configuration of the input arm changes e.g. by bending ofinput arm joints (e.g. towards the user). As, in some embodiments, thesurgical arm configuration is controlled by the input arm configuration,when the configuration of the input arm changes, in some embodiments,the user view of the input arm and camera view of the surgical armcontinue to correspond.

In some embodiments, insertion into a same region of a patient isdefined as where the arm and camera are inserted into a patient with asmall separation between insertion points (e.g. 0-20 cm or 0-10 cm or0-5 cm or lower or higher or intermediate distances or ranges) and/orwhere the arm and camera are inserted through a single port and/orthrough a single incision and/or through the same natural orifice (e.g.vagina, anus, mouth, esophagus, windpipe, nostril, ear canal.

In some embodiments, when the surgical arm and camera are insertedthrough different entry locations and/or entry locations in differentregions of a patient, and the surgical arm is advanced towards thecamera FOV, the input arm is adjusted to extend towards the user and/oruser support. In some embodiments, the camera view of the surgical armthen extends towards the camera corresponding with the user's view ofthe input arm which extends towards the user.

Alternatively or additionally, in some embodiments, the direction ofextension of the input arm is orientated based on an angle of entranceinto the patient of the camera and/or surgical arm.

In some embodiments, the surgical arm includes a rigid support portionand, in some embodiments, a distal end of the surgical arm including onemore joint is coupled to the rigid support portion (e.g. coupled to adistal end of the rigid support portion). In some embodiments, the inputarm is orientated based on an angle of the support portion with respectto an angle of entrance and/or FOV (e.g. center of the FOV) of thecamera.

In some embodiments, a control console includes more than one input arm,movement of which is used to control one or more surgical arms. In anexemplary embodiment, each input arm is used to control a surgical arm,e.g. in some embodiments, two surgical arms are used where one movementof each of two input arms controls one of the surgical arms.

In some embodiments, orientation of each input arm is adjusted based oninsertion points and/or angles of insertion and/or angle of the supportportion with respect to the camera (e.g. as described above) for thecorresponding surgical arm.

In some embodiments, the input arms have two possible configurations,extending towards a user and/or user support and extending away from auser and/or user support. In some embodiments, when vectors of insertionof surgical mechanical arm/s and the camera are directed towards eachother, the input arm is adjusted to extend towards the user. Conversely,in some embodiments, where the vectors of insertion are directed in thesame direction or not directed towards each other, the input arm isadjusted to extend away from the user.

In some embodiments, the input arms have a range of configurations wherevertical and/or horizontal angle of extension of the input arm isadjustable, based on the angle between (e.g. insertion angle) surgicalmechanical arm/s and the camera.

In some embodiments, a control console and/or a system processorreceives data regarding a selected surgical configuration. Data, forexample, including one or more of, a number of entry port/s (e.g. forsurgical mechanical arms), position of entry port/s, an angle of entryof one or more device (e.g. camera and/or surgical arm) a number ofdevices, data regarding which device/s are inserted through which entryport.

In some embodiments, a user selects a surgical configuration through asystem user interface (e.g. control console user interface). Forexample, by selecting from a menu of displayed options displayed on theuser interface. Alternatively or additionally, in some embodiments, auser selects a surgical configuration by orientating input arm/s.Alternatively or additionally, in some embodiments, a user selects asurgical configuration by positioning and/or inserting surgical devices.

In some embodiments, the processor receives data regarding the surgicalconfiguration from the user interface. Alternatively or additionally, insome embodiments, a system processor receives data regarding thesurgical configuration from one or more sensor. For example, one or moresensor measuring orientation of input arm/s. For example, one or moresensor measuring a separation and/or orientation of surgical devices(e.g. surgical arm/s and/or camera/s).

In some embodiments, orientation of extension of control console inputarm/s is adjusted, based on the selected surgical configuration e.g.manually and/or automatically by one or more actuator receivinginstructions from the processor. In some embodiments, surgical arm/s areinserted and/or orientated based on the selected surgical configuratione.g. manually and/or automatically by one or more actuator receivinginstructions from the processor.

A broad aspect of some embodiments of the invention relates to inputarm/s which are configured for comfortable and fatigue free manipulationby a user. Where measured movement of an input arm is used to controlmovement of a surgical arm, the shape of the input arm, for example,corresponding with the shape of the surgical arm.

An aspect of some embodiments of the invention relates to control of asurgical mechanical arm using measured movement of a jointed input arm,where a user manipulates the jointed input arm using hand and/or wristmovement. In some embodiments, one user arm is used to manipulate asingle jointed input arm. For example, in some embodiments, the usermanipulates a first input arm with their left arm and a second input armwith their right arm.

In some embodiments, a volume of possible positions of one or moreportion of a jointed input arm (e.g. an input arm handle) is defined byinput arm portion sizes and range of angles at each joint. In someembodiments, the input arm/s are configured so a user can move an inputarm through the volume using wrist movement of a single user arm, where,for example, the user's forearm remains on an armrest.

In some embodiments, the control console is configured for comfortableuser by a user, where distance between the input arms and/or between theinput arms and other portions of the control console (e.g. usersupport/s) is selected for user comfort and/or is adjustable.

In some embodiments, positions of a plurality of input arm segmentscoupled by freely moving joints are controlled by a user grasping asingle portion of the input arm e.g. a distal portion of the input armwhich, in some embodiments, includes or is a handle.

An aspect of some embodiments of the invention relates to an input arm,including a handle sized and shaped for manipulation by a user where theuser comfortably holds the handle in a tripod grasp and/or in aprismatic finger grasp (e.g. similar to grasps associated with holdingan elongated writing implement e.g. pencil, pen).

In some embodiments, whilst holding the handle in a tripod grasp, a usersupports a portion of the device with a user palm. A potential advantagebeing improved control of a position of the portion of the devicesupported by the palm. In some embodiments, the input device is sizedand/or shaped such that portion/s supported (e.g. directly contacted) bya user palm when the user is holding the handle in a tripod and/orprismatic finger grasp and/or supporting the handle between userfingers, include a flexion joint (flexion joints also herein termed“bendable joints”).

In some embodiments, the input arm includes one or more lock, such that,when the input arm is released by a user, the input arm remains in alast user-controlled configuration before the release. In someembodiments, the input arm includes one or more sensor (e.g. contactsensor e.g. located in the input arm handle) which is used to detect ifa user (e.g. a user's hand) is in contact with the handle and/or isgrasping the handle. In some embodiments, the sensor/s provides asignal, which is analyzed by a processor to assess whether the user'shand is in contact with the handle and/or is grasping the handle (e.g.by comparing the sensor signal/s with threshold/s). In some embodiments,the processor, upon identifying that a user has released the handle,sends one or more signal to the input arm instructing lock/s (e.g. whichin some embodiments include motors within the input device) to holdand/or lock the input arm in the last position before user release. Insome embodiments, sensor signals are analyzed by the processor (e.g.continuously and/or periodically) to identify resumption of contactand/or grasp (grasp, in some embodiments, corresponding to higher sensorvalues than contact which can be identified, e.g. by comparison with athreshold). Where, in some embodiments, upon identifying resumption ofcontact, the processor sends control signal/s to the lock/s to releaseso that the user can resume moving the input device to control thesurgical device.

A broad aspect of some embodiments of the invention relates to an inputarm where a user is able to control movement of the arm at jointsindependently.

An aspect of some embodiments of the invention relates to biasing of aninput arm into one or more configuration. In some embodiments, biasingis by one or more weights, attached to one or more portion of the inputarm. In some embodiments, a weight is attached to one or more input armportion. In some embodiments, the weight is configured to return theinput arm portion to which it is attached (e.g. under gravity) to a nullconfiguration. In some embodiments, a portion to which the weight isattached is coupled to another input arm portion by a rotational joint.In some embodiments, a weight is coupled to a portion distal of arotational joint. For example, in some embodiments, (e.g. when the inputarm includes a first and a second rotational joint) a weight is attachedto a portion distal of a first rotational joint and a portion distal ofa second rotational joint. In some embodiments, a weight is 10 g-1 kg,or 20 g-400 g, or 50 g-100 g, or lower or higher or intermediate weightsor ranges. In some embodiments, a weight is 0.1-10 times, or 0.1-0.5times, or 0.1-5 times, or 1-5 times, or lower or higher or intermediatemultiples of a weight of a section to which it is attached and/or atotal weight of the input arm.

In some embodiments, weight/s return the input arm to a straightconfiguration (e.g. where rotational axes are parallel) upon release ofthe input arm. In some embodiments, weight/s mean that rotation of oneportion does not result in rotation of a weighted portion of the inputarm.

In some embodiments, a mass of a weight is selected to providesufficient torque to overcome friction (e.g. at a rotational joint) torotate a portion of the input arm to which it is attached. In someembodiments, a mass of one or more weights is selected to lower a centerof gravity of one or more portion of the input arm below a central longaxis of the input arm (e.g. in a straight configuration) and/or one ormore portion of the input arm.

In some embodiments, weight/s are configured to return one or moreportion of input arm, upon release, to a null position e.g. undergravity. In some embodiments, weights are selected to bias the input armwithout increasing weight of the input arm to a level where a usermanipulating the arm is fatigued easily.

Potentially, weighting of the input arm improves user ability to controlrotational joints individually. For example, in some embodiments, (e.g.when a portion of the arm between the rotational joints is in a straightconfiguration) rotation of one rotational joint tends to generaterotation in other rotational joint/s e.g. rotational joints proximal tothe joint being rotated by a user. Potentially, weighting at therotational joint/s prevents and/or reduces the extend of rotation of ajoint due to rotation of another joint.

An aspect of some embodiments of the invention relates to and input armwhich includes more than one rotational joint where the joints havedifferent axes of rotation when the arm is in a straight configuration.In some embodiments, a bendable joint (e.g. pivot joint) connect therotational joints, for example the input arm including a first rotatablesection coupled to a second rotatable section by a bendable joint. Insome embodiments, axes of rotation of the rotational joints have adifferent separation from an axis of a flexion joint disposed betweenthe rotational joints. In some embodiments, the axes of the rotationaljoints are parallel and axially offset from each other, in at least onedirection, when the arm is in a straight configuration. Potentially,offsetting the rotational joints improves user ability to controlrotational joints individually, for example, when the user is grasping asingle portion of the input device (e.g. the handle). For example insome embodiments, rotation of one rotational joint tends to generaterotation in other rotational joint/s.

In some embodiments, the axial offset and/or difference in separationbetween the input axes and the flexion joint therebetween issufficiently small e.g. with respect to one or more dimension of theinput arm that a shape of the input arm continues to correspond to ashape of a surgical mechanical arm controlled by the input arm. In someembodiments, the difference in separation and/or axial offset is 0.5-20mm, or 0.5-10 mm, or 0.5-5 mm, or about 3 mm, or lower or higher orintermediate distances or ranges. In some embodiments, the difference inseparation and/or axial offset is 0.01-5%, or 0.01-0.1%, about 5% orlower or higher or intermediate percentages or ranges of a maximum inputarm portion thickness. In some embodiments, the difference in separationand/or axial offset is 0.005-5%, or 0.010-0.2%, about 0.015 or lower orhigher or intermediate percentages or ranges of a maximum input armlength. Where, in some embodiments, the surgical mechanical armrotational joints are coaxial when the arm is in a straightconfiguration and/or where axes of rotational joints have about the sameseparation from an axis of a flexion joint therebetween. In someembodiments, a maximum length of an input arm is 5-50 cm, or 5-30 cm, or10-30 cm or 15-25 cm or about 19 cm. In some embodiments, a maximumand/or average input portion width (e.g. diameter of a tubular inputportion) is 1-15 cm or 1-10 cm or 2-7 cm, or about 5.5 cm.

A broad aspect of some embodiments of the invention relates to an inputarm where control by a user of the arm remains comfortable for a rangeof input arm configurations, e.g. for a range of handle orientationswith respect to the user.

An aspect of some embodiments of the invention relates to an input armwhere more than one signal, generated by the input arm is used tocontrol movement of a single portion of a corresponding surgicalmechanical arm. In some embodiments, measured movement of more than oneportion (e.g. measurement by more than one sensor, each sensorgenerating a signal) of the input arm is used to control movement of asingle portion of the surgical arm. In some embodiments, measuredmovement of a portion of the input device and a user interface (e.g.switch, button, dial) control movement of a single portion of thesurgical arm. In an exemplary embodiment, both rotation of a body of aninput arm handle (e.g. about a handle long axis) and an input devicecontrol rotation of a portion of the surgical arm e.g. surgical arm endeffector. In some embodiments, the user interface is a rotation userinterface e.g. a dial which, in some embodiments, is disposed to an endof the handle coupled to the input arm. Potentially, more than onecontrol (e.g. at the handle) for a single movement enables comfortableuser control in different input arm configurations e.g. different handleorientations.

An aspect of some embodiments of the invention relates to an input armuser input with adjustable orientation. In some embodiments, one or moreinput arm user interface changes orientation with movement of the inputarm. In some embodiments, orientation changes due to friction between auser and the user interface. For example, in an exemplary embodiment, ahandle of an input arm includes a user input, the orientation of whichmoves under friction between a user finger and/or thumb as the handle ismoved by the user holding the handle. In some embodiments, orientationof one or more user interface changes orientation with respect to amoving input device portion under gravity (e.g. the user interface isweighted) for example, the user interface maintaining an orientationwith respect to the vertical for more than one (e.g. all) configurationof the input arm. In some embodiments, one or more user interfaceorientation is controlled by an actuator.

Before explaining at least one embodiment of the invention in detail, itis to be understood that the invention is not necessarily limited in itsapplication to the details of construction and the arrangement of thecomponents and/or methods set forth in the following description and/orillustrated in the drawings and/or the Examples. The invention iscapable of other embodiments or of being practiced or carried out invarious ways.

Exemplary Surgical System

FIG. 1 is a simplified schematic of a surgical system 100, according tosome embodiments of the invention.

In some embodiments, system 100 includes a surgical mechanical arm 102.In some embodiments, surgical mechanical arm 102 includes a firstflexible portion 101 coupled to a second flexible portion 103, coupledto a tool 105. In some embodiments, a distal portion of the surgicalmechanical arm (e.g. including portions 101, 103, 105) is coupled to asurgical mechanical arm support 107. In some embodiments, support 107 isrigid.

In some embodiments, surgical arm 102 is actuated by a motor unit 104.In some embodiments, surgical mechanical arm 102 is supplied withelectrical power e.g. for electrosurgery through motor unit 104. In someembodiments, motor unit 104 receives electrosurgical power from anelectrosurgical power generator (not illustrated).

In some embodiments, system 100 includes an input arm 106. In someembodiments, input arm includes a first flexion joint 150 and a secondflexion joint 152. In some embodiments, system includes one or moresensor 108 which senses position of one or more portion of input arm106. In some embodiments, sensor/s 108 measure movement betweenportion/s of the input device, for example, flexion at flexion joints150. 150 and/or rotation about rotational joint/s 160, 162, 174.

In some embodiments, system 100 includes a processor 110 which receivesa signal from sensor/s 108 and generates one or more control signal. Insome embodiments, processor 110 sends the generated control signal tomotor unit 108 which, in some embodiments, actuates movement of surgicalmechanical arm 106, based on the control signal.

In some embodiments, the processor instructs the motor unit to move thesurgical mechanical arm into a configuration where a shape of thesurgical arm corresponds to a shape of the input arm. For example, wherethe surgical device has about the same angles between correspondingsegments as the input device. Where, in some embodiments, angles betweensegments are measured as intersections between central long axes of thearm at rotational joints. For example, as illustrated by dashed lines onFIG. 1.

FIG. 2 is a simplified schematic of a surgical system 200, according tosome embodiments of the invention.

In some embodiments, surgical system 200 includes at least one surgicalmechanical arm, for example, a plurality of surgical mechanical arms202, 212 e.g. two surgical mechanical arms. In some embodiments,surgical mechanical arms are sized and/or shaped for insertion into ahuman patient's body 214.

In some embodiments, the system includes at least one motor unit, forexample, a plurality of motor units 204, 216, where, in someembodiments, each of surgical mechanical arms 202, 204 is actuated by amotor unit. For example, where a first surgical arm 202 is actuated by afirst motor unit 204 and/or a second surgical arm 212 is actuated by asecond motor unit 218.

In some embodiments, one or more motor unit and/or one or more surgicalarm is attached to a patient support surface 220 (e.g. a bed), forexample by a support 222. In an exemplary embodiment, one or more motorunit is attached to patient support surface 220. A potential benefit ofthe device being coupled to a bed is the ability to move and/or changean angle of the bed, for example, during surgery, while the deviceremains in the same position relative to the bed and/or patient.Alternatively, or additionally, in some embodiments, a device positionwith respect to the patient and/or the bed is adjustable, for example,before treatment with the device and/or during surgery.

In FIG. 2, patient 214 is illustrated in a suitable position forinsertion of the device into and/or through the vagina (and/or anusand/or undercarriage), where, for example, the patient's legs are apart(e.g. elevated and/or held apart e.g. held by stirrups which are notillustrated).

In some embodiments, surgical arms 202, 212 are controlled (e.g. by auser 232) at a control console 228. In some embodiments, movement ofsurgical arms 202, 212 is controlled. In some embodiments,electrosurgical charging of arms 202, 212 is controlled. In someembodiments, one or more motor unit (e.g. each motor unit 204, 218) isconnected to control console via data and/or electrical supplyconnections 242.

In some embodiments, control console 228 includes a plurality of userinterfaces: In some embodiments, control console 228 includes one ormore input arm 206, 230, where the control console is configured togenerate control signals upon movement of the arm/s. For example, insome embodiments, a processor (not illustrated) generates controlsignals when input arm/s are moved (e.g. as described regarding sensor108 and processor 110, FIG. 1). In some embodiments, one or more inputarm includes an additional user interface (not illustrated), forexample, one or more button and/or switch.

In some embodiments, control console includes a display 234. In someembodiments, display 234 is configured to display imaging of a surgicalzone, for example, to display images collected by a camera inserted intopatient 214 e.g. with surgical arms 202, 212. In some embodiments,display 234 is a touch screen configured to receive user input,potentially providing a user input.

In some embodiments, control console 228 includes one or more additionaluser interface 240 (e.g. button, switch) e.g. located on and/or neardisplay 234.

In some embodiments, system 200 includes connectivity to and/or includesan electrosurgical generator 224. In some embodiments, for example, asknown in the art of electrosurgery, electrosurgical generator 224supplies high-frequency (e.g. radio frequency) alternating polarityelectrical current. In some embodiments, electrosurgical generator 224is configured to supply different frequencies and/or powers, forexample, suitable for cutting and/or coagulating and/or desiccatingand/or fulgurating tissue.

In some embodiments, electrosurgical generator 224 is a part of controlconsole 228. Alternatively, in some embodiments, electrosurgicalgenerator 224 is a separate device the control console and/or motorunits, for example including connectivity to the electrosurgicalgenerator. For example, in an exemplary embodiment, electrosurgicalgenerator 224 is a Covidien Force FX ESU Electrosurgical Generator. Insome embodiments, supply to the motor units is via cable/s 226 whichare, for example, configured to transfer radio frequency electrosurgicalpower.

In some embodiments, one or more surgical mechanical arm 202, 212 issupplied with electrical power by a motor unit to which the arm isattached. In some embodiments, surgical arm/s are supplied (e.g.indirectly through motor unit/s) with power by electrosurgical generator224.

In some embodiments, electrosurgical generator 224 includes one or moreuser interface e.g. for control of supply of electrosurgical powersupply to arms 202, 212. In some embodiments, the electrosurgicalgenerator is controlled by a control console user interface e.g. 234and/or 240.

In some embodiments, control console includes a foot pedal 236.Alternatively or additionally, foot pedal 236 is provided as part ofand/or attached to electrosurgical generator 224. In some embodiments,foot pedal 236 is connected via a data and/or power connection 225 toelectrosurgical power generator 224. In some embodiments, foot pedal 236controls supply of electrosurgical power to the surgical mechanicalarm/s 202, 212.

In some embodiments, system 200 includes a processor (not illustrated)configured to receive signal/s from user input/s (e.g. one or more ofinput arm/s 206, 230, display 234, additional user interface/s 240, footpedal 236). In some embodiments, the processor sends control signals tomotor units 204, 218 and/or electrosurgical generator 224 e.g. based onsignal/s received from user input/s.

In some embodiments, the processor sends control signals to controlconsole actuator/s, for adjustment of portion/s of the control console.For example, in some embodiments, a user inputs a command through a userinterface (e.g. display 234) to adjust one or more portion of thecontrol console (e.g. position and/or orientation of input arm/s, heightof a user support). In some embodiments, the processor generates acontrol signal, based on the user inputted command, the processor, forexample, then sending the control signal to actuator/s to adjust thecontrol console. In some embodiments, the processor generates the signalbased on measurements, e.g. measured position/s and or movement/s ofinput arm/s. For example, in some embodiments, when input arms are moved(e.g. by a user) towards a collision, in some embodiments, a separationbetween the input arms is automatically increased, for example, bymovement of one or more input arm support.

In some embodiments, control console 228 includes a processor.Alternatively or additionally, in some embodiments, processing is hostedby an external processor which is, for example, configured to receiveuser input signal/s and/or send control signals to motor unit/s and/orthe electrosurgical generator.

In some embodiments, foot pedal 236 and/or electrosurgical generator 224include a processor configured to generate control signals (e.g. basedon sensed pressure of user 232 pressing on portion/s of foot pedal 236).Where, for example, electrical power supplied to motor units is varied208, 210 based on the control signals. In some embodiments, foot pedalcontrol signals do not pass through a control console processor.

In some embodiments, a first input arm 204 controls movement of firstsurgical arm 202 and/or a second input arm 230 controls movement ofsecond surgical arm 212. In some embodiments, a user positions and/ormoves an input arm 206 by grasping an input arm handle 238.

In some embodiments, a system includes an electrosurgical switchingunit, for example, connected between electrosurgical generator 212 andmotor units 204, 218 which, for example, switches electrosurgical powersupply (e.g. on and/or off) from the electrosurgical generator, forexample, upon receiving a signal (e.g. from a electrosurgical switchingunit user interface and/or from an external processor).

Exemplary Control Console

FIGS. 3A-B are simplified schematic views of a control console,according to some embodiments of the invention.

FIG. 3C is an enlarged portion of FIG. 3B according to some embodimentsof the invention.

In some embodiments, control console 328 includes a first input arm 306and a second input arm 330. In some embodiments, two input arms are usedto control one, two, or more than two surgical mechanical arms. Where,for example, a user selects surgical arms for control with the surgicalarms, for example, then changing and/or switching the surgical armselection.

Alternatively, in some embodiments, control console 328 includes oneinput arm and/or more than two input arms, for example, 3, 1-10, 1-5 orlower or higher or intermediate numbers of input arms. In someembodiments, each input arm controls a surgical instrument (e.g. asurgical mechanical arm). In some embodiments, more than one input armcontrols a surgical instrument and/or a single input arm is used tocontrol more than one surgical instrument.

In some embodiments, movement of a camera, e.g. laparoscopic camera, iscontrolled by movement of an input arm. In some embodiments, alaparoscopic camera is mounted on a mechanical arm, for example, formingor replacing an end effector of a surgical mechanical arm (e.g. asdescribed elsewhere in this document). For example, in some embodiments,a control console includes three input arms, one for control of each ofa first surgical arm, a second surgical arm and a laparoscopic camera.In some embodiments, a control console includes input arms of differentsizes. In some embodiments an input arm (e.g. a third input arm) issmaller than other input arm/s. For example, in some embodiments, acontrol console includes an input arm which is sized for control by oneor more user finger and/or thumb and/or for control by a user by asingle user hand, e.g. without the user needing to move their hand fromcontact with a handle (e.g. grip on the handle). In some embodiments, aminiature (e.g. with one or more dimension which is half that of aninput arm) third input arm is mounted to one or more input arm.

In some embodiments, the control console is mobile, for example, isconfigured to be moved around (e.g. within an operating theatre). Forexample, in some embodiments, the control console is sized and/or shapedfor ease of movement. For example, in some embodiments, control console328 has less than 3×2 meters, or less than 2×1 meters, or lower orhigher or intermediate footprint areas or ranges of footprint areas. Forexample, in some embodiments, control console weighs less than 200 kg,or less than 150 kg, or less than 100 kg, or about 80 kg, 20-100 kg, or60-80 kg, or about 72 kg or lower or higher or intermediate weights orranges of weights.

In some embodiments, control console 328 includes one or more wheel 348which are, for example, mounted to base 339. In some embodiments, one ormore wheel includes a lock and/or brake.

In some embodiments, an input arm is attached to control console 328 bya stand. For example, first input arm 306 is attached to control console328 by stand 370 and second input arm 330 is attached to control console328 by second stand 371. In some embodiments, an orientation of stand/s370, 371 with respect to control console 328 is adjustable. For example,in some embodiments, one or both of the stands are rotatable about astand long axis. Potentially adjustability of a stand enables a user toadjust input arm/s to desired position/s and/or orientations e.g. withrespect to a user and/or user support (e.g. seat 344 and/or armsupport/s 346). In some embodiments, height and/or lateral position ofone or more of stand/s 370, 371 is adjustable. In some embodiments, adirection of extension of input arm 306 from stand 300 is adjustablee.g. to change a direction of extension of the arm with respect to auser and/or user support. For example, in some embodiments, input arm306 is coupled to stand 370 by one or more joint (e.g. as describedregarding and/or illustrated joint 376, FIG. 3D).

In some embodiments, control console 328 includes one or more usersupport. For example, a seat 344 and/or one or more arm support 346.

In some embodiments, position of seat 344 and/or arm supports 346 areadjustable. In some embodiments, the seat and/or arm supports haveadjustable height and/or lateral position. For example, in someembodiments a base 329 of the control console includes one or morelinear rail. In an exemplary embodiment, seat 344 is linearly moveableon base 329 along seat linear rail 345. In an exemplary embodiments,seat 344 is height adjustable by a spring (e.g. a gas spring) and lockwhere the spring urges the seat towards a maximum height and the lock,when locked, holds the seat at a selected height position.

In some embodiments, input arms 306, 330 and/or arm rests 346 arecoupled to base 339 by an arm base 341. In some embodiments, arm base341 is moveable with respect to base 339 e.g. along one or more linearrails, for example, arm base linear rails 343 for vertical movement. Insome embodiments, the arm base is moveable in direction/s towards and/oraway from a back end of the control console 337 and/or seat 344 (e.g. onanother linear rail which is not illustrated). In some embodiments,input arm/s and/or arm rest/s are height adjustable with respect to armbase 341, for example, along linear rails (not illustrated). In someembodiments, arm/s are moveable e.g. towards and/or away from seat 344and/or back end 337, for example, moving on linear rail/s 351 on armbase 341. In an exemplary embodiment, linear rail/s 351 for movement ofinput arm/s are located on an underside of arm base 341. In someembodiments, for example, alternatively or additionally to linear rails,arm rest/s and/or input arm/s include spring and lock positionadjustment.

In some embodiments, a seat height (measured from a lowest point of thewheels to a top surface of the seat) is between and/or is adjustablebetween 200-700 mm or 390-530 mm, or lower or higher or intermediatedistances or ranges.

In some embodiments, an arm support height (measured from a lowest pointof the wheels to a top surface of the seat) is between and/or isadjustable between 300-1000 mm or 670-840 mm, or lower or higher orintermediate distances or ranges.

In some embodiments, a distance between arm rest supports (e.g. an armrest “reach”) is between and/or is adjustable between 50-700 mm or151-401 mm, or lower or higher or intermediate distances or ranges.

In some embodiments, an arm rest depth, where the depth, d (FIG. 3A) is100-200 mm or about 150 mm, or lower or higher or intermediate distancesor ranges.

In some embodiments, arm rests 346 are laterally adjustable, e.g. withrespect to base 329 is adjustable between 10-400 mm or 81-241, or loweror higher or intermediate distances or ranges.

In some embodiments, a seat diameter is 200-600 mm or about 380 mm, orlower or higher or intermediate distances or ranges

In some embodiments, for example, in addition or alternatively tochanging on orientation of input arm/s a position of one or more portionof the control console is adjustable with respect to the input arms. Forexample, to change a direction of extension of the arms with respect toa user and/or user support, in some embodiments, the user support/s aremoved. For example, rotating portion/s of the control console around theinput arm/s e.g. rotating the seat and/or arm supports e.g. around theinput arm/s. In some embodiments, the control console is configured fora user to use the input arm from more than one viewing direction of theinput arm. For example, in some embodiments, the control consoleincludes more than one seat (and optionally arm rest/s associated witheach seat), where the seats are at different positions around the inputarm/s (e.g. one seat on each side of the input arms, e.g. disposed on abase).

In some embodiments, the control console includes a display 334, forexample, for display of imaging during surgery (e.g. from a camerainserted with and/or mounted on surgical arm/s). Optionally, display 334is a touch screen and is configured to receive user inputs. In someembodiments, the console includes additional user interface/s, forexample, in some embodiments including one or more of an on/off switch340 a, a light indicator 340 b, and/or off button 340 c (e.g. emergencyoff button), user interface/s on the input arm/s. In some embodiments,height and/or lateral position of the display is adjustable. In someembodiments, an angle of a plane of the display e.g. with respect thecontrol console and/or user is adjustable.

In some embodiments, control console 328 includes one or more storagecompartment 325. In some embodiments, a storage compartment 325 islocated behind display 334. In some embodiments, storage compartment 324includes one or more door 323. In FIG. 3A door 323 is illustrated in anopen position. In FIG. 3B, door 323 is illustrated in a closed position.In some embodiments, storage compartment 325 is sized and/or shaped tohouse one or more surgical mechanical arm (e.g. surgical mechanical arm1 FIG. 1, 202, 212 FIG. 2, and/or one or more motor unit (e.g. motorunit/s 204, 218, FIG. 2).

In some embodiments, control console includes one or more power and/ordata connection. For example, as described regarding connections 242and/or 224 and/or 226 of FIG. 2. In some embodiments, the controlconsole includes one or more socket for attachment thereto of powerand/or data connections. In an exemplary embodiment, a front of control347 console includes sockets 349. In some embodiments, FIG. 3Cillustrates an enlarged view of sockets 349. In some embodiments, thecontrol console includes a power socket 349 a, an earth socket 349 b andsockets for connections to motor unit/s 349 c which include, forexample, data and/or power sockets.

Exemplary Input Arm

FIG. 3D is a simplified schematic side view of an input arm 306,according to some embodiments of the invention. In some embodiments, acontrol console includes more than one input arm, e.g. as described withrespect to FIGS. 3A-B.

In some embodiments, input arm 304 includes a plurality of sectionssequentially coupled by joints. In some embodiments, joints alternatebetween rotational joints and flexion joints. In some embodiments, inputarm 304 includes a proximal end 368 coupled to a stand 370 and a distalend 372.

In some embodiments, input arm 306 is coupled to stand 370 by a standconnection joint 376. In some embodiments, stand is a pivot joint. Insome embodiments, rotation of the arm about stand connection joint 376changes an orientation of input arm 304 with respect to stand 370.

In an exemplary embodiment, input arm 304 includes a first flexion joint350 (also termed “shoulder joint”) and a second flexion joint 352 (alsotermed “elbow joint”).

In some embodiments, the flexion joints are independently bendable (e.g.by a user). In some embodiments, one or more of flexion joints 350, 352are pivot joints. In some embodiments, one or more of flexion joints hasrestricted flexion, where, for example, a shape of the input armportions prevents flexion beyond a maximum angle. In some embodiments,one or both of flexion joints has maximal flexion of about 180°.

In an exemplary embodiment, input arm 306 includes four sections, where,for example, a first section 354 is coupled to a 376 stand connectionjoint 376 by a first rotational joint 360, first section 354 is coupledto a second section 366 by a first flexion joint 350, second section 366is coupled to a third section 364 by a second rotational joint 362, andthird section 364 is coupled to a fourth section 358 by a second flexionjoint 352.

In some embodiments, a user controls movement of input arm 306 byholding a handle 338 (e.g. as described regarding handle 2038, FIG. 20).In some embodiments, handle 338 is attached to fourth portion 358 by aconnector 375, where, in some embodiments, connector 375 is rigid.

In some embodiments, handle 338 extends in a direction towards secondflexion joint from connector 375. In some embodiments, handle 338 is hasan elongate shape where a long axis of the handle extends towards secondflexion joint from connector 375.

Extending towards e.g. instead of away from rotational joint means thatyou can have the handle sized nicely for gripping while not increasingthe volume of the possible positions. For example, in some embodiments along axis length of the handle is 10-100%, or 10-95% or 30-100%, or30-95%, or lower or higher or intermediate percentages or ranges of amaximum length of said input arm.

Optionally, in some embodiments, input arm 306 includes a thirdrotational joint 374. In some embodiments, handle 338 is rotatable e.g.with respect to fourth portion 358 about third rotational joint 374.

In some embodiments, an orientation of stand 370 is adjustable, withrespect to a control console (e.g. as described regarding FIG. 3A).

In an exemplary embodiment, button 378, activates ability of movement ofthe input arm about joint 374, for example, in some embodiments, inputarm 306 is held (e.g. locked) in position with respect to stand 370 and,in some embodiments, pressing on the button enables rotation (e.g.releasing a lock).

In some embodiments, to control movement of input arm 306, a user graspshandle 338. In some embodiments, handle 338 includes a loop 380, theuser, for example, inserting a finger (e.g. index finger) into loop 380.In some embodiments, handle 338 includes one or more user interface 382,384, 386 (e.g. as described regarding FIGS. 6A-B). In some embodiments,while grasping handle 338, a user interacts with one or more handle userinterface 382, 384, 386 (e.g. as described regarding FIG. 20).

In some embodiments, input arm 306 is connected to stand 370 byconnectors 390 and 392 (in an exemplary embodiment, connectors 390, 392are bolts) which, when removed, provide access to connection of theinput arm to stand 370 e.g. for removal and/or replacement of the inputarm from the stand.

FIG. 3E is a simplified schematic view of an input arm 306, according tosome embodiments of the invention. In some embodiments, FIG. 3Eillustrates a view of the input arm 306 illustrated in FIG. 3A and/orFIG. 3D where covers for portions of the arm and the handle have beenremoved to provide a view of inner elements of the input arm.

In some embodiments, input arm 306 includes a first and a second flexionjoint 308, 320.

In some embodiments, segments move against each other, during rotationof the segments about a flexion joint. For example, in some embodiments,portion 362 moves against segment 356 during flexing of first flexionjoint 350. In some embodiments, movement of portions against each otherduring flexion of one or more joint are configured to have low frictionmovement. For example, in some embodiments a first contacting portionhaving a brass surface in contact with a second contacting portionhaving a stainless steel surface.

In some embodiments, input arm 306 includes one or more sensor,configured to measure flexion at flexion joint/s and/or rotation atrotational joint/s. In some embodiments, sensor/s measure angle/s at oneor more joint e.g. an orientation of one portion with respect to anotherportion, where the portions are coupled by a joint. In some embodiments,one or more sensor is a magnetic differential sensor, where, forexample, a magnet is affixed to a first portion of a joint and amagnetic sensor is affixed to second portion of a joint which moves withrespect to the first portion (e.g. rotation and/or flexion). In someembodiments, the sensor senses a change in magnetic field. In someembodiments, magnetic sensor/s transfer sensor signal/s through cables,e.g. to a processor. Alternatively or additionally, in some embodiments,connection between sensor/s and a processor is wireless.

In an exemplary embodiment, for one or more joint e.g. for both thefirst and second rotational joints, the sensor is connected to the moredistal portion of the joint. In some embodiments, in the case ofmagnetic sensing, the magnet is connected to the more proximal portionof the joint. In some embodiments, for one or more joint, the sensor isconnected to the more proximal portion of the joint and the magnet isconnected to the more distal portion of the joint. Where a proximal endof the input arm is where it is connected to the stand and the distalend of the arm is at the handle.

In some embodiments, a first magnetic sensor 395 senses rotation offirst section 354 at first rotational joint 360 e.g. by sensing movementand/or rotation of a magnet (not visible in FIG. 3E). In someembodiments, the magnet is coupled to and/or mounted on and/or within ascrew.

In some embodiments, rotation of a second magnet 397 is measured e.g. bya magnetic sensor (not visible in FIG. 3E) e.g. to measure flexion atfirst flexion joint 350.

In some embodiments, a third magnetic sensor 399 senses rotation ofsecond section 362 with respect to third section 364 at secondrotational joint 362 e.g. by sensing rotation of a magnet (not visiblein FIG. 3E). In some embodiments, the magnet is mounted on and/or withina screw.

In some embodiments, rotation of a forth magnet 361 is measured e.g. bya magnetic sensor (not visible in FIG. 3E) e.g. to measure flexion atsecond flexion joint 352.

In some embodiments, a fifth magnetic sensor 398 senses movement e.g.rotation of dial user interface 386 e.g. with respect to forth section358 e.g. by sensing rotation of a magnet which rotates with dial 386. Insome embodiments, sensed rotation of dial 386 is used to controlrotation of a surgical mechanical arm end effector. Alternatively oradditionally, in some embodiments, handle 338 is rotatable about ahandle long axis e.g. as described regarding FIG. 3F.

In some embodiments, the input arm does not include sensors. Forexample, movement of the input arm being measured by sensor/s externalto the input arm For example, in some embodiments, movement of an inputarm is measured using motion capture technology where, for example, insome embodiments, movement of the input arm is inferred from imagescollected by one or more camera.

In some embodiments, electrical supply, for example, for sensor/s and/oruser inputs (e.g. on handle 338) is supplied to input arm 306. In someembodiments, data (e.g. from sensor/s within the input arm) is passedthrough the arm.

For example, through a stand (not illustrated), passing through standconnection joint 376. In some embodiments, electrical supply and/or datais transferred through one or more rotational joint by slip rings. Forexample, first slip ring 394 transferring power and/or data from standconnection joint 376 to segment 356 and second slip ring 396transferring power and/or data from portion 366 to portion 362.

In some embodiments, stand connection joint 376 includes a slip ring(not illustrated) for transfer of electrical power (and/or data) to theinput arm through a stand (e.g. stand 370 FIGS. 3A-B).

In some embodiments, cable/s pass power and/or data across one or moreof flexion joints 350, 352. In some embodiments, the cables aresufficiently long and/or have sufficient slack that flexion joints bendwithout tensioning the cables. Alternatively, in some embodiments,flexion joints also include slip rings for transfer of power and/ordata.

In some embodiments, handle 338 includes a slip ring 367 for powersupply to and/or data transfer to a handle user interface (e.g. 384 FIG.3B), where, an orientation of the handle user interface is adjustablewith respect to the handle, e.g. as described regarding handle userinterface 684 in FIGS. 6A-B.

In some embodiments, rotational joints (e.g. rotational joints) 356, 394share an axis of rotation.

FIG. 3F is a simplified schematic cross sectional view of a portion ofan input device handle 338, according to some embodiments of theinvention.

In some embodiments, control of a single movement of a surgicalmechanical arm is controlled by measured movement of more than one inputarm portion and/or controlled by more than one input arm user interface.Where a single movement is, for example, bending of a surgical devicejoint, rotation of a surgical device joint, actuation of a surgicaldevice tool. In some embodiments, control signal/s for a single type ofsurgical device movement (e.g. control signals controlling one or moreactuator e.g. a single surgical device actuator) are generated by morethan one sensor signal (e.g. from more than one sensor). In someembodiments, a surgical mechanical arm movement is controlled by both amovement of the input arm and by an input arm user interface.

In an exemplary embodiment, both rotation of a dial and rotation of abody 313 of handle of input device handle 338 control rotation of aportion of a surgical mechanical device, e.g. rotation of an endeffector of the surgical mechanical device. In some embodiments, anelongate body 313 of the handle 338 which is grasped by a user (e.g. asdescribed and/or illustrated regarding handle body 2013 FIG. 20) isrotatable e.g. about a long axis of the body of the handle.

In some embodiments, one or more sensor 398, 363 detect rotation of twomagnets 365 magnet 369. In some embodiments, a fifth magnet 365 moveswith movement of user interface 386 where, for example, fifth magnet 365is connected to user interface 386. In some embodiments, e.g. asdescribed regarding FIGS. 3A-E, user interface 386 is a dial. In someembodiments, a sixth magnet 369 rotates with rotation of body 313 ofhandle. In some embodiments, a fifth magnetic sensor 398 senses rotationof fifth magnet 365 and a sixth magnetic sensor 363 senses rotation ofsixth magnet 369. In some embodiments, the sensors have data and/orpower connections which run along and/or through a connecting portion375 to an input arm forth section 358.

A potential benefit of dual rotation controls on the handle ismaintained ease of control, for different orientations and/or user gripson the handle. For example, in some orientations of the handle, it isdifficult for a user to rotate the handle, in which case, the user mayuse the dial and vice versa, in orientations of the handle where it isdifficult for the user to rotate the dial.

In some embodiments, handle 338 includes a slip ring 373 for transfer ofpower and/or data through handle body 313, e.g. to one or more userinterface e.g. 382, 384 FIG. 3D.

Although magnets and magnetic sensors in FIG. 3F have been termed“fifth” and “sixth” it is to be understood that, in some embodiments,the handle illustrated in FIG. 3F is part of an input arm with less ormore than six magnets and/or magnetic sensors.

FIG. 4A is a simplified schematic isometric view of an input arm 406,according to some embodiments of the invention.

FIG. 4B is a simplified schematic section view of an input arm 406,according to some embodiments of the invention.

In some embodiments, FIG. 4B is a sectional view of the input armillustrated in FIG. 4A.

In an exemplary embodiment, input arm 406 includes four sections, where,for example, a first section 454 is coupled to a 476 stand connectionjoint 476 by a first rotational joint 460, first section 453 is coupledto a second section 466 by a first flexion joint 450, second section 466is coupled to a third section 464 by a second rotational joint 462, andthird section 464 is coupled to a fourth section 458 by a second flexionjoint 452.

In some embodiments one or more flexion joint includes ball bearings 452a, 450 a, and/or one or more rotational joint includes ball bearingse.g. 426 a FIG. 4C, 428 a FIG. 4D, potential benefits being robustnessof the joint and/or smooth movement and/or low friction movement ofportions of the input arm about the joint.

In some embodiments, input arm 406 includes one or more slip ring, 494,496, for example, the slip ring/s located at rotational joints forexample, for transfer of power and/or data through the input arm 406(e.g. as described regarding slip rings 394, 394 FIG. 3E).

In some embodiments, cable/s pass power and/or data across one or moreof flexion joints 450, 452. In some embodiments, the cables aresufficiently long and/or have sufficient slack that flexion joints bendwithout tensioning the cables. Alternatively, in some embodiments,flexion joints also include slip rings for transfer of power and/ordata.

FIG. 4C is a simplified schematic view of a portion of an input deviceincluding a first rotational joint 426, according to some embodiments,of the invention.

FIG. 4D is a simplified schematic view of a portion of an input deviceincluding a second rotational joint 428, according to some embodiments,of the invention.

In some embodiments, FIGS. 4C-D are enlarged portions of FIG. 4B.

In some embodiments, FIG. 4C illustrates a part of support portion 476and a part of first portion 420. In some embodiments, FIG. 4Dillustrates a part of second portion 422 and a part of third portion424.

In some embodiments, one or more rotational joint includes ball bearings426 a, 428 a. Potentially, ball bearings reduce friction at the joints.

In some embodiments, relative rotation of portions of the input devicecoupled at a rotational joint is measured by one or more sensor.

For example, referring to FIG. 4C, in some embodiments, a magnet 427 ismounted on a shaft (not visible in FIG. 4C) where first portion 420 isrotatable about the shaft. In some embodiments, a magnetic sensor 429,located within the first portion 420 senses rotation of the shaft withrespect to the first portion. In some embodiments, the magnet andmagnetic sensor are co-axial, for example, the magnetic sensor detectingchange in magnetic field.

For example, referring to FIG. 4D, in some embodiments, a magnet 415 ismounted on shaft 431 where second portion 422 is rotatable about shaft431. In some embodiments, a magnetic sensor 433, located within thethird portion 424 senses rotation of the shaft with respect to thirdportion 424. In some embodiments, the magnet and magnetic sensor areco-axial, for example, the magnetic sensor detecting change in magneticfield.

Visible in FIG. 4D are cables for transfer of power and/or data 335. Insome embodiments, do not terminate as illustrated but extend through thejoint.

Exemplary Volume of Input Arm Configurations

In some embodiments, the size and shape of the volume of possiblepositions of the input arm is defined by length of portions of the inputdevice and range of rotation and flexion of the joints.

FIGS. 3G-I are simplified schematic views of configurations of an inputarm 306 and outer contours 383, 385 of potential positions of the inputarm, according to some embodiments of the invention. In someembodiments, the volume of possible positions of input arm 306 isenclosed and/or partially described by spheres centered on a firstflexion joint 350.

FIG. 3G illustrates a single configuration of input arm 306 and, in someembodiments, contour 338 illustrates possible positions possiblepositions of a distal end of an input arm fourth portion 358. In someembodiments, contour 338 is a semicircle centered on first flexion jointand/or a portion of a circle, the edges of which are defined by stand370 and flexion joints 350, 352 which, in some embodiments, each open toa maximum angle. Where, in some embodiments the maximum angle is170-250°, or 170-220°, or about 180° or lower or higher or intermediateangles or ranges e.g. as illustrated in FIG. 3G. In some embodiments,input arm is rotatable about a first rotation joint 350 meaning that avolume of possible positions of the input arm includes a portion of asphere (e.g. a hemisphere) extending above a top and/or distal end(where, in some embodiments the top is the distal end) of stand 370.Where stand 370, in some embodiments, prevents rotation of arm portionsdistal of the first flexion joint about the first flexion joint of morethan about 170-250°, or 170-220°, or about 180° or lower or higher orintermediate angles or ranges.

In some embodiments, once flexion joints are rotated about firstrotational joint 360 such that the flexion joints are below the topand/or distal end of stand 370, e.g. disposed in space laterally aroundstand 360, the volume of possible positions of the input arm is reduced.For example, to a quarter sphere, where contour 387 FIG. 3H illustratespossible positions of the distal end of fourth section 358 for the inputarm configuration illustrated in FIG. 3H.

Referring now to FIG. 3I, in some embodiments, an elongate handle 338extending from fourth portion 358, extends a volume of possiblepositions of the input arm, for at least some angles of rotation offirst flexion joint 350 and/or angles of rotation of second flexionjoint 352. Where the volume, at least in some regions, is extended to acontour of a sphere 385 centered on first rotational joint 350.

In some embodiments, a volume of possible positions of an input arm isapproximately spherical, where a diameter of the sphere is 100-800 mm,or 100-500 mm or about 370 mm, or lower or higher or intermediate rangesor values.

In some embodiments, a control console includes a plurality of inputarms (e.g. two) where the volume of possible positions of the input armis the same shape and/or size. Alternatively, in some embodiments, acontrol console includes input arms where the volume of potentialpositions of one input arm is different in shape and/or size to that ofanother input arm, input arms, for example, being different sizes and/orwith different possible extent of rotation and/or flexion at rotationaljoints and flexion joints respectively.

In some embodiments, an input arm is configured such that a usercomfortably moves the input arm throughout the volume of possiblepositions of the arm using wrist movement of a single arm, where, forexample, user forearms remain resting on armrests. In some embodiments,both of two input arms are configured such that the user comfortablycontrols movement of each arm with wrist movement of one hand.

In some embodiments, a separation between attachment of the input armsto the control console (e.g. separation between centers of stands 370,371 FIG. 3A) is selected for user comfort. In some embodiments,separation is reduced below a sum of the lengths of the input arms, theinput arms potentially colliding. A potential benefit of input armsbeing close together being user comfort (e.g. when a user controls aninput arm with each user hand). In some embodiments, separation betweena center of extension of a proximal arm portion from a stand and/or aseparation between stand long axes 50-500 mm, or 200-500 mm, or about340 mm, or lower or higher or intermediate ranges or values.

In some embodiments, different input arms, e.g. as described in thisdocument (e.g. input arm 106 FIG. 1, 206, 230 FIG. 2, 306 FIGS. 3A-F,406 FIGS. 4A-D, 506 FIG. 5) have a volume of possible positionsincluding one or more feature as described in this section “Exemplaryvolume of input arm configurations” and/or illustrated in one or more ofthe figures to which this section refers.

Exemplary Biasing of Exemplary Input Arm

Returning back now to FIG. 4B, in some embodiments, input arm 406 isbiased. For example, by one or more weight which is e.g. attached to oneor more input arm portion e.g. attached to and/or within a hollow (e.g.tubular) arm portion. In an exemplary embodiment, combined weights ofweights 430 and 432 bias first portion 420 about axis 426 a and weight534 biases weight of second portion 424 about axis 428 a.

In some embodiments, the input arm is biased (e.g. one or more weight isselected) to return the input arm to a null position e.g. under gravitye.g. upon a user releasing the input arm.

In some embodiments, a weight is selected to generate sufficient torqueto overcome friction in moving (e.g. rotating) one or more portion ofthe input arm. In some embodiments, a weight is selected to maintain acenter of gravity of one or more portion (e.g. a portion, the entireinput arm) below a central long axis of the portion and/or input arm.

In some embodiments, a weight on a portion is configured to return theportion, under gravity, to a null orientation, upon release of theportion. In an exemplary embodiment, weights 420 and 432 together weigh100-200 g, or 130-150 g or about 140 g or lower or higher orintermediate ranges or weights. In some embodiments, one or more ofweights 434, 436, 438 include (e.g. are constructed from) stainlesssteel.

Alternatively or additionally, in some embodiments, biasing isimplemented e.g. using magnetic biasing and/or using one or moreactuator e.g. one or more spring, one or more motor.

In some embodiments, the input arm is biased so that the null positionis where flexion joints are disposed at a further separation from aninput arm support and/or attachment of the input arm to the console(e.g. stand 370 FIG. 3D) than other portions of the input arm. Forexample, in some embodiments (e.g. as illustrated in FIG. 3D) attachmentof the input arm extends downwards and the null position (e.g. asillustrated in FIGS. 3A and 3D) is where the flexion joints are aboveother portion/s of the arm. In some embodiments, a null position iswhere the arm is straight, e.g. with each flexion joint open to about180° (e.g. as illustrated in FIGS. 3A and 3D). A potential benefit ofthis being that the flexion joints are biased in a position that bendingof the joints is not restricted by the input arm support (e.g. stand 370FIG. 3D). A further potential benefit is ease of manipulation of theinput arms by the user, where, for example, bending the input armsupwards, in some embodiments is more comfortable and/or easier tocontrol than bending the input arms downwards.

In some embodiments, biasing forces (e.g. weight of the weights) areselected such that movement of the input arm/s has enough inertia thataccidental movement of the input arm does not occur and/or so that butnot so much inertial that moving the input arms causes excessive userfatigue.

FIG. 5 is a simplified schematic side view of an input arm 506,according to some embodiments of the invention.

In an exemplary embodiment, input arm 506 includes four sections, where,for example, a first section 554 is coupled to a 576 stand connectionjoint 576 by a first rotational joint 560, first section 553 is coupledto a second section 566 by a first flexion joint 550, second section 566is coupled to a third section 564 by a second rotational joint 562, andthird section 564 is coupled to a fourth section 558 by a second flexionjoint 552.

In some embodiments, one or more portion of the input arm is weighted.For example, input arm including one or more of weights 530, 534 whereweighting, for example, includes one or more feature as described and/orillustrated regarding weights 430, 434 FIG. 5.

Exemplary Method of Retroflection, Exemplary Control of Retroflection

FIG. 21 is a simplified schematic side view of a surgical mechanicalarm, in different configurations, according to some embodiments of theinvention.

In some embodiments, bending (e.g. retroflection) movement of a surgicalmechanical arm is controlled to reduce an area (e.g. within a patient)in which the arm is located, for example, during part of a surgicalprocedure. In some embodiments, the mechanical arm is controlled toprevent contact or collision of the arm with an obstacle 2177. In someembodiments, the obstacle is a portion of patient tissue for example, aninner wall of the abdomen. In some embodiments, the surgical arm isinserted into a patient through an incision where, in some embodiments,the patient has been insufflated. Insulation, for example, providing aworking area 2179 for the surgical device within the patient, where theworking area is, in some embodiments, at least partially bounded by usertissue 2177, where, in some embodiments, user tissue is an inner wall ofthe abdomen.

In some embodiments, the surgical device is a surgical mechanical armincluding a plurality of flexible portions 2101 a-c, 2103 a-c, disposedbetween a proximal and a distal end of the surgical arm. Where, in someembodiments, a proximal end 2181 of the arm is coupled to actuator/sconfigured to actuate movement of the surgical arm and, in someembodiments, the distal and is coupled to an end effector. In someembodiments, the end effector 2105 a-c is configured to be electricallycharged e.g. for electrosurgery.

FIG. 21 illustrates retroflection of the surgical arm to configuration Cwith (illustrated by configuration B) and without (illustrated byconfiguration A) contacting and/or broaching boundary 2177.

FIG. 22 is a flow chart of a method of surgical device retroflection,according to some embodiments of the invention.

At, 2200, in some embodiments, a bendable portion distal of one or moreother bendable portions of a surgical mechanical arm is bent. In someembodiments, the most distal bendable portion of the surgical arm isbent.

At, 2202, in some embodiments, a proximal bendable portion is bent toretroflect the surgical arm.

In some embodiments, a surgical mechanical arm is retroflected asdescribed and/or illustrated regarding FIGS. 21-22, upon identifyingpotential collision of the surgical arm with an obstacle, which is, insome embodiments, the abdominal wall.

In some embodiments, a user identifies the potential collision e.g.using images collected by a laparoscopic camera. In some embodiments,the user then retroflects the arm by manipulating an input armcontrolling the surgical arm. For example, by first bending an input armsecond flexion joint and then bending an input arm first flection joint(e.g. flexion joints as described in one or more embodiment, elsewherein this document).

In some embodiments, the surgical system includes circuitry configuredto identify a possible collision (e.g. hosted by one or more processor,e.g. processor 110 FIG. 1). For example, in some embodiments, a possiblecollision is identified using data from one or more sensor and/or one ormore camera and/or imaging data from one or more imager (e.g. CT, MRI,ultrasound, x-ray).

In some embodiments, upon identifying a possible collision, controlinstructions are displayed to a user, for example, by one or more userinterface e.g. user interface/s 234, 240 FIG. 2). In some embodiments,instructions include display e.g. visual and/or audio guidingretroflection e.g. by first bending an input arm second flexion jointand then bending an input arm first flexion joint.

In some embodiments, upon identifying a possible collision, a userinterface and/or the surgical device is prevented from bending into acollision.

For example, in some embodiments, upon detecting a collision, movement/sof the input arm are prevented (e.g. by one or more brake) and/orcontrol of the surgical arm by movements of the input arm is disabledand/or movement of the surgical arm is stopped.

For example, in some embodiments, if user manipulation of the inputdevice would cause the surgical device to collide, a shape of thesurgical device fails to correspond and/or match that of the inputdevice. For example, in some embodiments, a user retroflects the inputdevice arm by bending the input arm at the first input device flexionjoint. Circuitry then changes the control signal to instruct bending atthe second bendable portion followed by bending at the first bendableportion.

FIGS. 23A-E are simplified schematic top views of an input arm,according to some embodiments of the invention.

FIGS. 24A-B are simplified schematic side views of an input arm,according to some embodiments of the invention.

In some embodiments, FIGS. 23A-E and FIGS. 24A-B illustrate control ofretroflection of a surgical arm, e.g. as described above. In someembodiments, solid contour lines illustrate a contour of a path of aninput device handle 2338 FIGS. 23A-E, 2438 FIGS. 24A-B duringretroflection.

A potential benefit of retroflection e.g. as described above e.g. wherea first input device flexion joint is bent and then a second inputdevice joint is bent is that the path that a user's hand follows (e.g.while holding the handle) during retroflection is sized to becomfortable for a user e.g. sized and/or shaped for control by userwrist movement. For example, where the contour extends to a lesserextent than that of a contour where retroflection is by only bending thefirst flexion joint 2350, 2450 e.g. as illustrated by dashed linecontours 2411 FIG. 23E, 2411 FIG. 24A. For example where the contourextends further than that of a contour 2355, 2455 where retroflection isby only bending the second flexion joint 2352, 2452, a potential benefitbeing ease of accurate control of bending when the contour is of alarger extent.

Exemplary Rotational Joints

Referring back now to FIG. 4B. In some embodiments, an input armincludes one or more rotational joint which, when the arm is in astraight configuration (e.g. when flexion joints are 450, 452 are openedto 180°, e.g. as illustrated in FIG. 4B) is axially offset from one ormore other rotation joint, where axially offset refers to the joints notsharing an axis of rotation.

In some embodiments, an axis of rotation 426 a of first rotational joint426 of first rotational joint 426 an axis of rotation of 428 a of secondrotational joint 428 have different separations from one or more flexionjoint.

In some embodiments, the separation of axes of rotation 426 a, 428 afrom flexion joint/s is in at least one direction, or in more than onedirection. In some embodiments, difference in separation is in onedirection only.

In some embodiments, when the arm is in a straight configuration, axis426 a is parallel to axis 428 b. When rotational joints are co-axialtorque applied by a user at the handle to rotate one of the rotationaljoints, for example, when arm portion/s between the rotational jointsare in a straight configuration, tends to cause rotation of both joints.Potentially, axial offset, when the arm is in a straight configurationof enables a user holding a portion of the input arm (e.g. handle 438,e.g. with a single hand) to control (e.g. manually) position of jointsindividually.

Exemplary Input Arm Handle

In an exemplary embodiment, user interfaces located on an input armhandle are used to control one or more of linear motion, tool actuationand pause-resume of control for one or more surgical mechanical arm.

FIGS. 6A-B are simplified views of an input arm handle 638, according tosome embodiments of the invention.

In some embodiments, handle 638 includes controls for linear movement ofa surgical mechanical arm. In an exemplary embodiment, handle 638includes a first button 682 a to control (e.g. activate) linearadvancement and a second button 682 b (e.g. to activate) to controllinear retraction of a surgical mechanical arm.

In some embodiments, handle 638 includes an user interface 682 c which,in some embodiments, is a button, for pausing of control of a surgicalmechanical arm by the input arm to which handle 638 is attached. In someembodiments, pausing is of movement of a single surgical arm, in someembodiments, pausing is of a plurality of surgical arms, e.g. two and/orall surgical arms of the system.

In some embodiments, handle 638 includes an user interface which, insome embodiments, is a rotation knob 686, for control of rotation of asurgical mechanical device tool (e.g. tool 105 FIG. 15). In someembodiments, a user rotates the rotation knob 686 to rotate the tool.

In an exemplary embodiment, input arm handle includes a lever button684. In some embodiments, a user presses on lever button 684 to controlactivation of a surgical device tool, for example, opening and/orclosing of a tool (e.g. tool 105 FIG. 1). Exemplary surgical devicetools include grasper, scissors. In an exemplary embodiment, a userpresses on lever button 684 to open a tool and releases the button (insome embodiments, lever button 684 is protruding as illustrated in FIGS.6A-B when in a relaxed state, e.g. in some embodiments, the lever buttonis spring biased to an open position).

In some embodiments, an orientation of one or more user interface isadjustable with respect to the handle. In an exemplary embodiment, anorientation of lever button 684 is adjustable with respect to handle638. FIG. 6B illustrates a different orientation of lever button 684than that illustrated in FIG. 6A. In some embodiments, lever button 684freely rotates, for example, with friction under a user's thumb, e.g. asthe handle is moved by the user. In some embodiments, electrical anddata contacts to the lever switch are attached by a slip ring (notillustrated).

Exemplary Input Arm Configurations and Corresponding Exemplary SurgicalArm Configurations

FIGS. 7-10 are exemplary simplified schematic configurations of an inputarm and corresponding configurations of a surgical mechanical arm,according to some embodiments of the invention.

FIG. 7 illustrates an exemplary configuration where an input arm 706 isin a straight configuration where central long axes 704 of input armsegments are aligned and a corresponding configuration of a surgicalmechanical arm 702 a, where central long axes 708 of surgical mechanicalarm flexible portions are aligned.

FIG. 8 illustrates an exemplary configuration where an input arm 806 isretroflected by bending at second flexion joint 852 which is fullyflexed to an angle αi. In some embodiments, angle αi is 100-300°, or150-250°, or 170-220° or lower or higher or intermediate angles orranges. In an exemplary embodiment, αi is about 210°. FIG. 8 illustratesan exemplary corresponding configuration of a surgical mechanical arm802, where the surgical arm is retroflected by an angle αs whichcorresponds to angle αi, e.g. is the same as angle αi and/or is within0-5° or 0-10° of angle αi and/or is within 0.1-5% of αi, or larger orsmaller or intermediate angles, ranges or percentages.

FIG. 9 illustrates an exemplary configuration where an input arm 906 isretroflected to about 180° by partial bending at first flexion joint 950and second flexion joint 952. FIG. 9 illustrates an exemplarycorresponding configuration of a surgical mechanical arm 902, which isretroflected by about 180° by partial bending of first flexible portion901 and second flexible portion 903.

FIG. 10 illustrates rotation of an input arm 1006 about a firstrotational joint 1060 and corresponding rotation of a surgicalmechanical arm 1002 at a first flexible portion 1001.

Exemplary Adjustment of Exemplary Control Console

In some embodiments, position of portion/s of the control console areadjusted to enable particular configuration/s of surgical arm/s, whereof surgical arm configuration (e.g. including bending angle of flexibleportions and/or rotational angle at rotational joints) is based onmeasured configuration of the input device (e.g. including bending angleat flexion joints and/or rotational angle at rotational joints).

For example, in embodiments where surgical arms are directed towardseach other, input arms are positioned such that the input arms do notinterfere (e.g. touch and/or collide with) each other. For example, insome embodiments, position of attachment of two input arms to thecontrol console is separated by a distance which is at least a sum ofthe lengths of the two input arms. For example, in some embodiments,input arms are positioned with different heights of attachment to thecontrol console, for example, such that when the input arms are directedtowards each other, one arm is below the other.

In some embodiments, position and/or orientation of control consoleportion/s (e.g. input arm/s, support/s, display/s) is adjusted for usercomfort. In some embodiments, for different configurations of the inputarms (e.g. oriented away or towards each other, e.g. bent or straight),position and/or orientation of attachment of input arm/s to the controlconsole is adjusted. For example, in some embodiments, where input armsare directed towards each other, distance between attachments of thearms to the control console is increased, e.g. providing a user withmore space.

In some embodiments, position of portion/s of the control console areadjusted for user comfort, for example, in some embodiments, aseparation between attachment of input arms to the control consoleand/or between arm rest/s is selected for a comfortable separationbetween user arms. For example, in some embodiments, e.g. where inputarms are angles away from each other and/or when the arms are bent,separation between attachment is reduced below a sum of the lengths ofthe input arms, e.g. closer input arms being more comfortable for a userto control (e.g. when a user controls an input arm with each user arm).

In some embodiments, positioning of the input arm/s is manual. Where,for example, a user manually moves alternatively or additionally, insome embodiments, orienting of the input arm/s is at least partiallyautomatic, for example where actuator/s move the input arm/s based on asignal received from a processor, where, in some embodiments, aprocessor generates the signal upon receiving a user input.

Exemplary Corresponding Configurations

FIG. 11 is a flow chart of a method of surgical device control,according to some embodiments of the invention.

At 1100, in some embodiments, a surgical configuration is selected for aplurality of surgical devices including at least one camera. In someembodiments, a surgical configuration is selected for at least onesurgical mechanical arm (e.g. two surgical mechanical arms) and a cameraconfigured to capture images of the surgical mechanical arm/s.

In some embodiments, the surgical configuration includes laparoscopicinsertion of one or more surgical device, for example, the surgicalarm/s and/or camera e.g. through one or more surgical.

In some embodiments, a surgical configuration includes insertion point/sand/or region/s through which surgical devices (e.g. camera and/orsurgical arm/s) are inserted. For example, including selecting a numberand/or a shape and/or location of insertion points.

Exemplary insertion points include a natural body orifice, an incisedopening (e.g. including an incision in a natural body orifice) and/orany other opening allowing access to the patient's body. In someembodiments, a port element (e.g. a laparoscopic port) is coupled to apatient's body at an insertion point and through which one or moresurgical instrument (e.g. surgical arm, camera) accesses the patient'sbody.

In some embodiments, a surgical configuration includes an angle of entryof one or more surgical device into the patient, e.g. of one or moresurgical arm into the patient and/or of one or more camera into thepatient. For example an angle of at least a portion of surgical arm(e.g. a surgical arm rigid support portion) with respect to a surface ofa patient.

An exemplary surgical configuration is, for example, where all surgicaldevices, e.g. one or more surgical mechanical arm and/or a camera areinserted through a single incision and/or port (e.g. single portlaparoscopic surgery SILS). In some embodiments, the single port iswithin a natural orifice (e.g. vagina, anus, mouth, nostril, ear canal,esophagus, trachea).

A further exemplary surgical configuration is, for example, where aplurality of surgical devices are inserted through a plurality ofincisions and/or ports, for example, where surgical arm/s are insertedthrough a different port to a camera, for example where a plurality ofsurgical arms are inserted through more than one port.

In some embodiments, a surgical configuration is selected by one or moreof steps 1102, 1104, 1106.

At 1102, in some embodiments, a user selects one or more feature (e.g.as described regarding step 1100) of a surgical configuration through auser interface e.g. user interface 234 and/or 240 FIG. 2, e.g. display334 FIG. 3A. In some embodiments, a user selects a surgicalconfiguration from a set of surgical configurations e.g. stored in amemory. For example, in some embodiments, a user selects a surgicalconfiguration from a display of surgical configuration options.

In an exemplary embodiment, the system includes two surgicalconfigurations, a surgical configuration where a camera and at least onesurgical arm are inserted into a patient in a same direction through asingle incision, and a surgical configuration where the camera and atleast one surgical arm are inserted into a patient in differentdirections through different incisions.

In some embodiments, a user enters data into the user interface and aprocessor receiving the data generates, from the data, a surgicalconfiguration. For example, in some embodiments, a user selects asurgical procedure and/or enters and/or accesses information regarding apatient (e.g. imaging data). The processor then uses the entered and/oraccessed data to select a surgical configuration.

At 1104, in some embodiments, a user selects a surgical configuration bypositioning and/or inserting surgical devices. Where, for example, oneor more sensor senses a position and/or angle of entry of the surgicaldevices. In some embodiments, the sensor is part of a surgical device.For example, in some embodiments, the sensor is the laparoscopic camera,and images collected by the camera e.g. of one or more surgical arm e.g.identifying a spatial relationship between the surgical arm and thecamera, are used to detect a selected surgical configuration. Forexample, in some embodiments, a position sensor (e.g. which, in someembodiments, is part of one or more of the surgical devices) includes aposition sensor e.g. sensing a spatial relationship between the surgicaldevices (e.g. surgical arm/s and a camera).

At 1106, in some embodiments, a user selects a surgical configuration byorientating one or more input arm. In some embodiments, a sensedorientation of the input arm (e.g. direction of extension of the inputarm from a stand e.g. stand 370 FIG. 3A) is used to define one or morefeature of a surgical configuration. In some embodiments, additionallyor alternatively, a sensed position of a user's line of sight is used inselecting the surgical configuration. For example, in some embodiments,a position of a user's head and/or line of sight is sensed using one ormore position sensor and/or using a camera (e.g. where a user's line ofsight is measured by identifying facial feature/s in collected cameraimages). In some embodiments, a user's line of sight is inferred fromcollected data e.g. user height e.g. inputted by the user into the userinterface.

At 1108, in some embodiments, one or more portion of a control consoleis positioned based on and/or corresponding to the selected surgicalconfiguration, for example, one or more input arm (e.g. input arm/s 306,330 FIGS. 3A-B). In some embodiments, positioning is before a start totreatment (e.g. before surgical arm/s are inserted into a patient).Optionally, in some embodiments, positioning is during a treatment e.g.as direction of surgical arm/s changes during treatment.

At 1110, optionally, in some embodiments, selected surgicalconfigurations are compared to check that they match. For example, insome embodiments, a processor compares a surgical configuration selectedat a user interface with a sensed configuration of surgical device/sand/or portion/s of the control console (e.g. of the input arm/s). Insome embodiments, if a discrepancy is detected an alarm is issued (e.g.through a user interface) and/or part of the surgical system e.g.electrosurgical power e.g. actuation of surgical arms is disabled.

In some embodiments, a surgical configuration selected and the controlconsole is configured (e.g. by adjusting the orientation of one or moreinput arm) before surgical devices are set up and/or treatment usingsurgical device/s is initiated.

In some illustrations (e.g. FIGS. 12A-16), dashed lines emanating from acamera represent a FOV of the camera.

FIGS. 12A-C are simplified schematics of a surgical system including acontrol console 1228 configured for a surgical configuration where aplurality of surgical devices 1202, 1290 are inserted into a patient1214 from different directions and/or at different insertion regions,according to some embodiments of the invention.

In some embodiments, at least a first and a second surgical device areinserted into patient 1214. For example, in some embodiments, the firstsurgical device is a camera, which is inserted and then a secondsurgical device, a surgical mechanical arm is inserted (or a pluralityof surgical mechanical arms). In some embodiments, camera images providefeedback to a user for control of insertion of the surgical arm/s. Insome embodiments, surgical arm/s are inserted until the surgical arm/sare within the camera FOV.

Alternatively, in some embodiments, surgical arm/s are inserted and thena camera is inserted.

In some embodiments, the patient's abdominal cavity is insufflated e.g.before and/or after insertion of camera 1290 and/or surgical arm 1202.

In some embodiments, a surgical mechanical arm 1202 e.g. as illustratedin FIG. 12A, is inserted through an undercarriage and/or patient'spelvic floor and/or through a natural orifice e.g. vagina, anus and thecamera is inserted through an abdominal incision e.g. through theumbilicus.

In some embodiments, control console 1228 includes at least one inputarm 1206 where measured movement of the input arm is used to controlmovement of surgical mechanical arm 1202.

In some embodiments, for example, as described regarding FIG. 11, anorientation of input arm 1206, with respect to a user's line of sight1232 and/or with respect to a user support, corresponds with anorientation of surgical arm 1202 with respect to a camera 1290 view ofsurgical arm 1202.

In some embodiments, input device arm 1206 has two possibleconfigurations. Where, for example, a first configuration illustrated inFIG. 12A is where the input arm extends towards a user where an angle ofextension of a proximal portion of the input arm from a long axis ofsupport 1270 (and/or to the vertical) is e.g. about 90°. In someembodiments, a second configuration is illustrated in FIG. 13C where anangle of extension of a proximal portion of the input arm from a support1370 is away from the user e.g. at an angle of about 270° from thevertical and/or from a long axis of support 1370.

In some embodiments, an angle of extension of the input armperpendicular to the vertical and/or to the long axis of support 1270 isnot adjusted to correspond to the surgical configuration. For example,the angle being adjusted for user comfort and/or the input device havinga fixed angle of extension e.g. for each of the two possibleconfigurations.

In some embodiments, e.g. for selecting a corresponding input armconfiguration to a surgical configuration, a vector of a direction ofinsertion 1209 of camera 1290 is projected onto an axis 1219 of adirection of insertion of surgical arm device 1202. In some embodiments,if the vectors of insertion 1221 of surgical arm 1202 and a projectedvector 1217 of the camera are towards each other, then an input armcorresponding to the first or second surgical device is orientatedtowards a user, for example, in a first configuration e.g. as describedabove and/or as illustrated in FIG. 12A. The surgical arm insertionvector may be projected onto an axis of a direction of insertion of thecamera to achieve the same result.

In some embodiments, a user manually matches the input deviceconfiguration to a surgical device configuration. Additionally oralternatively, in some embodiments, one or more sensor performs thevector analysis e.g. as described above.

In some embodiments, the input device configuration is selected based oninsertion points, where, in some embodiments, for insertion throughdifferent points (e.g. different ports), the first input deviceconfiguration is selected, where the input arm extends towards the useris selected. In some embodiments, when insertion is through a same areaand/or orifice and/or incision, the second input device configuration isselected, where the input arm extends away from the user (e.g. asillustrated in FIGS. 13A-C).

In some embodiments, the control console is configured by changing anorientation of an input arm support 1270 with respect to one or moreuser support, for example a user seat 1244 (and/or user arm rest/s whichare not illustrated in FIG. 12A). In some embodiments, to configure thecontrol console, an orientation of the input arm, e.g. an orientation ofextension of the input arm from support 1270 is adjustable by moving theinput arm with respect to a control console base 1229 (e.g. rotating theinput arm about a joint 1276 by which it is attached to support 1270e.g. as described regarding joint 376 FIGS. 3A, 3C).

In some embodiments, an angle in a vertical plane and/or a plane of asupport 1270 long axis is based on e.g. matched to correspond to asurgical configuration. For example, as illustrated by in FIG. 12B, anangle, θ2, of extension of an input arm 1206, with respect to a user'sview vector 1232 is based on an angle θ1 between a camera insertionvector 1290 and a surgical arm insertion vector 1221. In someembodiments, input arm 1206 is continuously adjustable in the verticalplane and/or a plane of a long axis of support 1270 e.g. between 90-180°of the vertical and/or a plane of a long axis of support. In someembodiments, input arm 1206 has a discrete number of configurations e.g.between 90-180° the vertical and/or a plane of a long axis of support.

In some embodiments, FIG. 12B illustrates the surgical system of FIG.12A after retroflection of surgical arm 1202 the retroflectioncontrolled by retroflection of input arm 1206.

In some embodiments, during use of the surgical system, the surgicalarm/s moves with respect to the camera. For example, as illustrated byFIG. 12C where surgical arm 1202 has been retroflected e.g. to treat asurgical target (e.g. as described in U.S. patent application Ser. No.15/401,045). In some embodiments, as a configuration of surgical arm1202 is controlled and/or or matched to movement of input arm 1206, whenthe configuration of the surgical arm changes during use of the system,the input arm configuration continues to correspond to the surgical arm.

FIGS. 13A-B are simplified schematic side views of a plurality ofsurgical devices 1390, 1392 inserted through the same insertion regionof a patient 1314, according to some embodiments of the invention.

FIG. 13C is a side view of a control console 1328 configured tocorrespond to a surgical configuration of FIG. 13A and/or FIG. 13B,according to some embodiments of the invention.

In some embodiments, e.g. as illustrated by FIG. 13A surgical mechanicalarm/s 1302 and camera 1390 are inserted through an abdominal port and/orincision e.g. in the umbilicus.

In some embodiments, e.g. as illustrated by FIG. 13B, surgicalmechanical arm/s 1302 and camera 1390 are inserted through the sameport, for example, through a port within a natural orifice e.g. thevagina.

For example, as described above, in some embodiments, FIG. 13Cillustrates a second input device configuration.

FIG. 14A is a side view of a simplified schematic of a plurality ofsurgical devices 1490, 1402 inserted through the same insertion regionof a patient 1414, according to some embodiments of the invention.

FIG. 14B is a top view of a simplified schematic of a plurality ofsurgical devices 1490, 1402 inserted through the same insertion regionof a patient 1414, according to some embodiments of the invention.

FIG. 14C is a top view of a control console configured to correspond toa surgical configuration of FIGS. 14A-B, according to some embodimentsof the invention.

In some embodiments, an angle in a horizontal plane and/or a planeperpendicular to a support 1470 long axis is based on e.g. matched tocorrespond to a surgical configuration. For example, as illustrated byin FIG. 14C, an angle, α2°, of extension of an input arm 1406, withrespect to a user's view vector 1432 is based on an angle α1° between acamera insertion vector 1490 and a surgical arm insertion vector 1421.In some embodiments, input arm 1406 is continuously adjustable in thehorizontal plane and/or a plane perpendicular to a long axis of support1470 e.g. between 90-180°. In some embodiments, input arm 1206 has adiscrete number of configurations e.g. between 90-180°.

FIG. 15 is a simplified schematic of a surgical system including acontrol console 1528 configured for a surgical configuration where aplurality of surgical mechanical arms 1502, 1512 are inserted through aplurality of ports according to some embodiments of the invention. Insome embodiments, ports are illustrated as circles.

In some embodiments, an orientation of input arms 1506, 1530 withrespect to a user (e.g. sitting on seat 1544) and/or with respect to thecontrol console, is based on general direction of approach of a surgicalmechanical arm through a port and/or into a patient. For example, asillustrated in FIG. 15, surgical mechanical arms 1502, 1512 are insertedthrough ports and directed towards each other (e.g. to approach asurgical target) and input arms 1506, 1530 are angled towards eachother. In some embodiments, e.g. as described with respect to FIGS.14A-C, angles of extension of input arm/s 1530, 1506 are based on (e.g.matched to correspond to) angles of insertion of surgical arms 1502, 15with respect to an angle of insertion of camera 1590.

FIG. 16 is a simplified schematic of a surgical system including acontrol console 1628 configured for a surgical configuration where aplurality of surgical devices 1202, 1290 are inserted into a patient1214 at different insertion regions, according to some embodiments ofthe invention. In some embodiments, camera 1690 is inserted through adifferent insertion point than surgical arm/s 1602 but the devices 1690,1602 extend in the same general direction (e.g. a vector of insertion ofone of the devices projected onto an axis of the vector of insertion ofthe other device are not directed towards each other, are directed inthe same direction). In some embodiments, input arm 1628 extends awayfrom user 1632, when different entrance points and/or ports are used forcamera 1590 and surgical arm/s 1602.

Exemplary Adjusting of Exemplary Control Console for ExemplaryCorresponding Configurations

FIG. 17A is a simplified schematic of a control console 1728 where aninput arm 1706 is orientated in a forwards configuration, according tosome embodiments of the invention.

FIG. 17B is a simplified schematic of a user 1732 using a controlconsole 1728 where an input arm 1706 is orientated in a forwardsconfiguration, according to some embodiments of the invention.

FIG. 18A is a simplified schematic of a control console 1828 where aninput arm 1806 is orientated in a backwards configuration, according tosome embodiments of the invention.

FIG. 18B is a simplified schematic of a user 1832 using a controlconsole 1828 where an input arm 1806 is orientated in a backwardsconfiguration, according to some embodiments of the invention.

In FIGS. 17A-B and 18A-B a single input arm (1706, 1806) is visible,however, in some embodiments, (e.g. as illustrated in FIGS. 3A-B),control console 1728 includes more than one input arm, for example, twoinput arms. In some embodiments, movement and/or orientation of inputarm 1706, 1806 (e.g. as described below) is performed for additionalinput arm/s (e.g. a second input arm), simultaneously and/orsequentially and/or alternatively to movement with input arm 1706, 1806.

In some embodiments, a user adjusts one or more portion of a controlconsole. In an exemplary embodiment, when orientation of input arm/s ischanged e.g. for a different surgical configuration e.g. as describedregarding step 1908, FIG. 19 and/or FIGS. 17A-B, and/or one or moreportion of a control console is adjusted. For example, as describedregarding step 1910 of FIG. 19.

In some embodiments, one or more adjustment of the control console isillustrated by changes illustrated between FIGS. 17A-B and FIGS. 18A-B.

For example, in some embodiments a height of one or more portion of thecontrol console is adjusted, e.g. a height of the portion from theground and/or height of the portion with respect to one or more othercomponents of the control console e.g. with respect to the input arm1706, 1806. For example, in some embodiments, a height of a seat 1744,1844 and/or arm rest/s 1746 and/or a display 1734, 1834 is adjusted.

For example, in some embodiments, lateral position of one or moreportion of the control console is adjusted, e.g. a position of theportion with respect to the input arm/s 1706, 1806. For example, in someembodiments, a lateral position of a seat 1744, 1844 and/or arm rest/s1746 and/or a display 1734, 1834 is adjusted.

Exemplary User Control of Exemplary Input Arm

In some embodiments, a user controls an input by grasping a 1722 handleof input arm 1706. In an exemplary embodiment, when input arm/s 1706 aremoved from a forwards position (e.g. illustrated by FIGS. 17A-B) to abackwards position (e.g. as illustrated by FIGS. 18A-B) a position of ahandle 1738 of the input arm moves in a direction towards a user (userdirection) and/or away from display 1734 and moves to a position lower(e.g. with respect to the ground). In some embodiments, for example,potentially improving comfort for a user one or more of arm rest/s 1746and/or seat 1844 and/or display 1824 are moved lower and/or towards in auser direction. In some embodiments, an angle of display 1824 ischanged, for example with respect to an attachment of the display to thecontrol console.

In some embodiments, one or more of display 1734, input arm 1706 (and,in some embodiments, additional input arm/s), arm rest 1746 (and, insome embodiments, additional arm rest/s, e.g. in some embodiments,control console includes an arm rest for each input arm), and seat 1744are mounted to a base 1739 and/or are moveable (e.g. with respect to thebase) on horizontal and/or vertical rails e.g. disposed within and/ormounted on the base. In some embodiments, one or more component isreleased to effect upwards vertical movement (e.g. is biased by a gasspring) and/or downwards force is exerted to effect downwards verticalmovement (and/or to lower the component onto base 1729, 1829).Alternatively or additionally, in some embodiments, one or morecomponent (e.g. seat) is attached to the base by a screw attachment andvertical movement is effected by rotating the component. In someembodiments, a component (e.g. seat 1744) is locked into a desiredposition.

Exemplary Controlled Retroflection of Input and Surgical Arms

In some embodiments, one or more portion of a control console isadjusted during a surgical procedure. For example, in some embodiments,an angle of connection of an articulated input arm configured to controlmovement of a surgical mechanical arm, with respect to a support ischanged. In some embodiments, the input arm is used to retroflect thesurgical arm, within a patient's body, an angle of connection of theinput arm to a support is then changed, without moving the surgical arm(e.g. control is paused). Optionally, in some embodiments, position ofone or more portion of a control console to which the input arm isattached is changed, e.g. a position of a seat and/or a position of armrest/s and/or a position of one or more display. In some embodiments,after change of angle of the input arm and/or position of controlconsole portion/s are changed, control of surgical arm movements by theinput arm are resumed.

FIG. 19 is a flow chart of a method of surgical mechanical arm movementcontrol, according to some embodiments of the invention. In someembodiments, the steps of the flow chart of FIG. 19 are performed usinga single input arm to control movement of a single surgical mechanicalarm. Alternatively, in some embodiments, more than one input arm is usedin control and/or more than one surgical mechanical arm is controlled.The steps of the flow chart of FIG. 19 are performed by movement of afirst input arm to control movement of a first surgical mechanical armand by movement of a second input arm to control movement of a secondsurgical mechanical arm where control of the arms (e.g. insertion and/orretroflection) is simultaneous and/or sequential and/or alternating.

At 1900 a surgical mechanical arm is inserted into a subject. In someembodiments, the surgical mechanical arm is inserted manually. In someembodiments, a user controls automated insertion of the surgicalmechanical arm. For example, in some embodiments, a user inputs controlinstructions through one or more user interface to control linearmovement of the surgical mechanical arm (e.g. buttons 682 a, 682 b FIGS.6A-B). Where linear movement, is for example, effected by one or moreactuators (actuation of linear movement of the surgical mechanical arme.g. as described in U.S. patent application Ser. No. 15/501,862).

In some embodiments, insertion of the mechanical arm is partially manualand partially automated. For example, a user positioning and/orpartially inserting the surgical mechanical arm, with further insertionbeing automated.

At 1902 the surgical mechanical arm is retroflected.

In some embodiments, surgical mechanical arm is retroflected by bendingat a first flexible portion (e.g. first flexible portion 101 FIG. 1).For example, where bending is controlled by a user bending a firstflexion joint of an input device e.g. 350 FIGS. 3A-I, 550 FIG. 5.

In some embodiments, surgical mechanical arm is retroflected by bendingat a second flexible portion where, in some embodiments, bending iscontrolled by a user bending a first flexion joint of an input device.For example, as illustrated in FIG. 8.

In some embodiments, surgical mechanical arm is retroflected by bendingat a first flexible portion and a second flexible portion, where, insome embodiments, bending is controlled by a user bending a first and asecond flexion joint of an input device. For example, as illustrated inFIG. 9.

In some embodiments, steps 1900 and 1902 occur, concurrently, at leastpartially. For example, in some embodiments, the surgical mechanical armis inserted as it is retroflected, e.g. linear advancement movementsalternating with bending at one or more surgical mechanical arm flexibleportion and/or linear advancement movements occurring concurrently withbending at one or more surgical mechanical arm flexible portion.

At 1904, in some embodiments, control of movement of the surgicalmechanical arm is paused. For example, in some embodiments, a userenters a pause instruction through a user interface (e.g. by pressing onbutton 682 c FIG. 16)

At 1906, in some embodiments, optionally, the input arm is straightened.

At 1908, in some embodiments, an angle of the input arm with respect toa control console to which it is attached is changed. For example, in anexemplary embodiment, the input arm is rotated about a joint (e.g. standconnection joint 376 FIG. 3D) from a first position where a direction ofthe arm is generally extending towards a user to a second position wherethe arm is generally extending away from a user. In some embodiments,the input arm is rotated by 180°.

At 1910, in some embodiments, portion/s of the control console areadjusted for use of the input arms in the second position. For example,position of one or more of arm rests (e.g. 346 FIG. 3A), a seat (e.g.344 FIG. 3A), a display (324 FIG. 3A).

In some embodiments the order of steps 1906, 1908 and 1910 isinterchangeable.

Exemplary User Control of Exemplary Input Arm

FIG. 20 is a simplified schematic of a user 2032 manipulating an inputarm 2006, according to some embodiments of the invention.

In some embodiments, user 2032 holds a handle 2038 between one or more afinger 2032 f (some fingers are not visible in FIG. 20) and a thumb 2032t. In some embodiments, a user holds handle 2038 in a tripod graspand/or in a prismatic finger grasp (e.g. similar to grasps associatedwith holding an elongated writing implement). In some embodiments, auser grasps the handle in a palmar grasp e.g. wrapping fingers and thethumb around a length of the handle.

In some embodiments, handle 2038 is sized and/or shaped for a user tocomfortably hold the handle between an adult finger and thumb (e.g. in atripod and/or prismatic grasp) and/or for a user to grasp the handle(e.g. in a palmar grasp). For example where an average width (e.g.diameter) is 2 mm-150 mm, or 5 mm-100 mm, or 10-50 mm, or 20-60 mm, orabout 40 mm, or lower or higher or intermediate dimensions or ranges. Insome embodiments, handle 2038 is elongate, for example, with a lengthwhich enables grasp/s described above. For example with a long axislength of 10-300 mm, or 20-200 mm, or 50-150 mm, or 70-130 mm or 90-130mm, or 100-120 mm, or about 110 mm or lower or higher or intermediatelengths or ranges. In some embodiments, handle 2038 has a generallycylindrical shape.

In some embodiments, a user holds handle 2038 such that a user thumb2032 t is positioned over a user interface 2084 (e.g. a lever button,e.g. 384 FIG. 3D, 684 FIGS. 6A-B). In some embodiments, handle 2084includes a plurality of user interfaces 2082 are positioned on thehandle such that a user is able to control the plurality of userinterfaces with the user's thumb e.g. without changing user grasp on thehandle.

In some embodiments, handle 2038 is configured (e.g. sized and/orshaped) such that a user with a thumb at user interface 2084 is able(e.g. concurrently) to control a user interface 2086 disposed at an end(e.g. proximal end) of the handle (e.g. 386 FIG. 3D, 686, FIGS. 6A-B).For example, using a user's finger e.g. without changing user grasp onthe handle and/or while the user's thumb remains in a region of userinterface 2084. Where, for example, dial user interface 2086 is 10-150mm, or 10-100 mm or 10-50 mm or lower or higher or intermediatedistances from user interface 2084.

In some embodiments, user 2032 supports a second flexion joint 2052 inthe user's palm e.g. as illustrated in FIG. 20. Potentially, this graspenables the user to control position of both second flexion joint 2052and a first flexion joint 2050, e.g. by force exerted by the user at thehandle (e.g. with the user's finger/s and/or thumb) and/or at the firstflexion joint (e.g. with the user's palm).

In some embodiments, one or more input arm user interface is used tocontrol a surgical mechanical arm, e.g. actuation of an arm tool e.g.opening and/or closing of a tool (e.g. gripper, scissors e.g. 105 FIG.1), for example, as described regarding FIG. 3F. Alternatively oradditionally, in some embodiments, input device user interface/s areused to control other portions of the system, for example, the displayof the control console (e.g. display 334 FIG. 3A).

In some embodiments, input arm and/or control console user interfacescontrol linear movement of the surgical arm (e.g. into and/or out of apatient) and/or pausing and/or resuming of control of movement of thesurgical arm by the input arm. e.g. as described regarding userinterfaces 682 a-c FIG. 6A.

In some embodiments, handle 2038 includes one or more finger loop,through with a user inserts a finger, e.g. as described and/orillustrated regarding loop 380 FIG. 3D.

General

It is expected that during the life of a patent maturing from thisapplication many relevant control consoles for surgical systems will bedeveloped and the scope of the terms control console, input arm,surgical mechanical arm is intended to include all such new technologiesa priori.

As used herein the term “about” refers to ±20%.

The terms “comprises”, “comprising”, “includes”, “including”, “having”and their conjugates mean “including but not limited to”.

The term “consisting of” means “including and limited to”.

The term “consisting essentially of” means that the composition, methodor structure may include additional ingredients, steps and/or parts, butonly if the additional ingredients, steps and/or parts do not materiallyalter the basic and novel characteristics of the claimed composition,method or structure.

As used herein, the singular form “a”, “an” and “the” include pluralreferences unless the context clearly dictates otherwise. For example,the term “a compound” or “at least one compound” may include a pluralityof compounds, including mixtures thereof.

Throughout this application, various embodiments of this invention maybe presented in a range format. It should be understood that thedescription in range format is merely for convenience and brevity andshould not be construed as an inflexible limitation on the scope of theinvention. Accordingly, the description of a range should be consideredto have specifically disclosed all the possible subranges as well asindividual numerical values within that range. For example, descriptionof a range such as from 1 to 6 should be considered to have specificallydisclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numberswithin that range, for example, 1, 2, 3, 4, 5, and 6. This appliesregardless of the breadth of the range.

Whenever a numerical range is indicated herein, it is meant to includeany cited numeral (fractional or integral) within the indicated range.The phrases “ranging/ranges between” a first indicate number and asecond indicate number and “ranging/ranges from” a first indicate number“to” a second indicate number are used herein interchangeably and aremeant to include the first and second indicated numbers and all thefractional and integral numerals therebetween.

As used herein the term “method” refers to manners, means, techniquesand procedures for accomplishing a given task including, but not limitedto, those manners, means, techniques and procedures either known to, orreadily developed from known manners, means, techniques and proceduresby practitioners of the chemical, pharmacological, biological,biochemical and medical arts.

As used herein, the term “treating” includes abrogating, substantiallyinhibiting, slowing or reversing the progression of a condition,substantially ameliorating clinical or aesthetical symptoms of acondition or substantially preventing the appearance of clinical oraesthetical symptoms of a condition.

It is appreciated that certain features of the invention, which are, forclarity, described in the context of separate embodiments, may also beprovided in combination in a single embodiment. Conversely, variousfeatures of the invention, which are, for brevity, described in thecontext of a single embodiment, may also be provided separately or inany suitable subcombination or as suitable in any other describedembodiment of the invention. Certain features described in the contextof various embodiments are not to be considered essential features ofthose embodiments, unless the embodiment is inoperative without thoseelements.

Although the invention has been described in conjunction with specificembodiments thereof, it is evident that many alternatives, modificationsand variations will be apparent to those skilled in the art.Accordingly, it is intended to embrace all such alternatives,modifications and variations that fall within the spirit and broad scopeof the appended claims.

All publications, patents and patent applications mentioned in thisspecification are herein incorporated in their entirety by referenceinto the specification, to the same extent as if each individualpublication, patent or patent application was specifically andindividually indicated to be incorporated herein by reference. Inaddition, citation or identification of any reference in thisapplication shall not be construed as an admission that such referenceis available as prior art to the present invention. To the extent thatsection headings are used, they should not be construed as necessarilylimiting.

What is claimed is:
 1. A surgical system comprising: a surgicalmechanical arm comprising a plurality of surgical arm sectionssequentially coupled by surgical arm joints; an input arm comprising: aplurality of input arm sections sequentially coupled by input armjoints; and an elongate handle: sized and shaped to be held between ahuman adult's thumb and one or more finger, where a maximum dimension ofsaid handle perpendicular to a handle long axis is 5 mm-15 mm and a longaxis length of said handle is 20-200 mm; coupled to a distal end of saidinput arm by a flexion joint; extending proximally with respect to amost distal input arm section so that a user grasping said handle bendssaid flexion joint to hold said handle above other portions of the inputarm; at least one sensor configured to measure movement of one or moreof said sections; and circuitry configured to receive a measurementsignal from said at least one sensor and to generate a control signal,based on said measurement signal for control of movement of saidsurgical mechanical arm.
 2. The surgical system of claim 1, where one ormore of said plurality of sections are sized such that a user holdingsaid elongate handle is able to support one or more section with theuser's palm of the hand holding the handle.
 3. The surgical system ofclaim 2, wherein a portion of said input arm includes a protrusion whichprotrudes from a body of said input arm, said protrusion at a distancefrom said handle and sized and shaped to be held in a user's palm of ahand holding the handle.
 4. The surgical system of claim 3, wherein saidprotrusion is at least a portion of a flexion joint.
 5. The surgicalsystem according to claim 1, wherein said input arms sections arealternatively coupled by rotational and flexion joints.
 6. The surgicalsystem according to claim 5, wherein said flexion joints are bendable ina single bending plane.
 7. The surgical system according to claim 6,wherein one or more of said flexion joints is bendable by at least 120°.8. The surgical system according to claim 6, wherein one or more of saidflexion joints is bendable by at least 180°.
 9. The surgical systemaccording to claim 6, wherein said flexion joints are bendable in onerotational direction about said single bending plane from a straightconfiguration.
 10. The surgical system according to claim 1, whereinsaid input arm includes a first flexion joint, a second flexion joint, afirst rotational joint and a second rotational joint.
 11. The surgicalsystem according to claim 10, wherein said flexion joints are eachbendable by at least 120°.
 12. The surgical system according to claim 1,wherein said handle extends proximally with respect to a most distalinput arm section.
 13. The surgical system according to claim 1, whereinsaid handle extends towards a most distal input arm joint.
 14. Thesurgical system according to claim 13, wherein said most distal inputarm joint is a flexion joint.
 15. The surgical system according to claim1, wherein a long axis length of said handle is 30-100% of a maximumlength of said input arm.
 16. The surgical system according to claim 14,wherein said at least one sensor comprises a magnetic sensor configuredto measure movement of a magnet mounted on one of said portions.
 17. Acontrol console for control of a medical surgical device comprising: acontrol console base; a seat attached to said control console base; aninput arm attached to said control console base comprising: a supportcoupled to said control console base; a proximal end coupled to saidsupport; a distal end; a handle section; a plurality of sectionssequentially coupled by input arm joints, extending from said proximalend where said plurality of sections terminates at said distal end withsaid handle section; an armrest attached to said control console base; afirst volume of possible positions of said handle section said firstvolume defined by lengths of said sections and; a second volume of userhand positions when a user sitting at said seat resting a forearm ofsaid user on said armrest, said second volume defined by a position ofsaid armrest and by a size of said user arm; wherein said first volumeis contained by said second volume, for average human adult armdimensions.
 18. The control console according to claim 17, wherein saidhandle extends proximally with respect to a most distal input armsection.
 19. The control console according to claim 17, wherein saidhandle extends towards a most distal input arm joint.
 20. The controlconsole according to claim 17, wherein a long axis length of said handleis 30-100% of a maximum length of said input arm.
 21. The controlconsole according to claim 17, wherein said first volume is a portion ofa sphere.
 22. The control console according to claim 21, wherein saidsphere is of 200-500 mm diameter.
 23. The control console according toclaim 17, comprising a first input arm and a second input arm coupled tosaid control base according to said input arm, said first volume of saidfirst input arm contained by a second volume of a first user hand, saidfirst volume of said second input arm contained by a second volume of asecond user hand.
 24. The control console according to claim 23,comprising a first armrest and a second armrest; wherein said secondvolume of said first user hand is defined by a position of said firstarmrest; and wherein said second volume of said second user hand isdefined by a position of said second armrest.
 25. The control consoleaccording to of claim 17, wherein said input arms sections arealternatively coupled by rotational and flexion joints.
 26. The controlconsole according to claim 25, wherein said flexion joints are bendablein one rotational direction about said single bending plane from astraight configuration.